Agenda item

This report sets out the Director of Public Health’s Annual Report for 2019-20.

Discussion:

Members considered the Director of Public Health’s Annual Report for 2019-20.  The report also included the discussion of the report that took place at the Health and Wellbeing Board.

The following issues were discussed:

·       Longstanding levels of deprivation in parts of Medway – the point was made that the areas with high levels of deprivation identified in the report had not improved in many years in spite of attempts to address this. This lack of resilience in these communities had been a factor in higher rates of Covid-19, the effects of which had further worsened resilience. The Director of Public Health commented that, as well as dealing with the impact of Covid and learning lessons from the pandemic, a system wide approach was needed to tackle long term structural issues and to break cycles of inter-generational poverty. However, such changes could not happen overnight. The regeneration plans for Medway formed part of this approach. He was also leading on a Kent and Medway population health management programme to tackle underlying health conditions. The Director emphasised the important role education played in health and that public health would be supporting the system led approach referred to by the development of the child friendly Medway initiative which would encompass all children. Children’s hubs in future would focus on prevention and education as well as the delivery of services.

In response to a question, the Director of Public Health clarified that residing in an area did not itself lead to worse outcomes and a person’s whole life context had to be taken into account.

·       Monitoring outcomes – the lack of milestones in the report was referred to and it was suggested there should be regular reports to the Committee on progress in achieving the Annual Report’s objectives so that recommendations could be made on where resources could be re-allocated to tackle health inequalities. The Director of Public Health advised there were lots of different ways in which outcomes could be influenced across the system. Outcomes were monitored in two ways. Firstly, the indicators in the Annual Report were monitored in detail via the Joint Health and Wellbeing Strategy by the Health and Wellbeing Board. Secondly some indicators were also Council Plan targets and monitored through the Council Plan monitoring process. Comprehensive action plans sat underneath these monitoring reports Also, each Annual report provided an overarching look back on the outcomes of previous reports. With regard to a suggestion that the monitoring reports could be reformatted for the Committee with a RAG rating to provide Members with an overview of progress, the Director of Public Health undertook to look at whether a simplified, heat map type report could be provided to the Committee, but this needed to take into account some measures were long term in nature.

·       Protecting mental health services – the likelihood of a significant increase in demand for mental health services post Covid-19 and the importance of working with partners to protect these services was referred to.

·       Voluntary and Community Sector (VCS) – the point was made that the Public Health team had worked very closely with the VCS during the pandemic and their partnership had significantly improved. Going forward this partnership would continue to be important. The Director of Public Health concurred with this point and noted that without the work of the VCS, Medway would have fared very differently during the pandemic.

·       Eating Disorders – a concern was raised that the emphasis on tackling obesity could send the wrong message to people suffering with eating disorders. The Director of Public Health commented that his team commissioned specialist eating disorder services and recognised that BMI was just one factor in a person’s health.

·       Greenspaces – the importance of green and open spaces was highlighted, noting this had been particularly importance during the periods of lockdown. The planning system should ensure people had access to an outside space. The Director of Public Health commented that the importance of outdoor spaces was reflected in various strategies and strategic plans.

·       Public Health work across the Council - whether the work the public health team were involved in across the council in planning, housing, education and skills etc could be reported to the Committee was suggested.

·       Smoking during pregnancy – in terms of how long this was monitored after the mother had given birth, the Director of Public Health advised that health visitors monitored whether the mother or anyone else in the household was smoking and intervened where necessary.

·       Education, skills and health - the Director of Public Health acknowledged this connection and commented his membership of the Skills Board and the Youth Justice Board gave him the ability to influence this issue. The Skills Board was also working with partners to bridge the gap between the emerging job market and the skills employers needed for these jobs.

·       Life expectancy – noting that the differences in life expectancy between men and woman was greater in Medway than nationally, how this was being addressed was queried. The Director of Public Health acknowledged this was a challenge and women were catching up to men and the gap was narrowing. His aspiration was to raise levels for both men and women and the data was available to target interventions where they were most needed.

·       Ward level information – the importance of Members receiving ward level information was referred to.

·       Public Health and the pandemic – several Members expressed their appreciation for the team’s work during the pandemic and the significant contribution made by public health.

Decision:

The Committee agreed to:

a)      note the comments of the Health and Wellbeing Board.

b)      note the Annual Public Health Report, including its findings and recommendations.

c)      consider whether the Committee should receive regular reports from the Health and Wellbeing Board.

(In accordance with Council Rule 12.6, Councillors McDonald, Murray and Price asked that their votes in favour be recorded.)