KONP (Keep Our NHS Public) Birmingham comments on BCC Public Health Strategy

The document does not really live up to its billing as a “strategy” i.e. a high-level plan of action. A lot of the proposed “What can we influence ” and “What do we want to do about it” are somewhat weak and woolly, being largely statements of laudable aspiration but without much specific substance. The sections get weaker as the document progresses e.g. no specifics are given for “addressing poverty” and there’s a lot of “want to develop” without a hint of the costs or organisational implications.

The document does not baseline the current Council provision on public health; it doesn’t indicate the current resources/financial expenditure and it doesn’t indicate the future expenditure/possible cuts to resources. Initiatives such as the “Start Well Program” are quoted without describing these to the non-cognoscenti, similarly use of jargon like “foundation stage”.

Section 7.2 focuses on the individual; the “whole systems approach” somehow fails to consider the wider context e.g. healthy eating is not so easy when the only affordable locally available food is pre-packaged and you don’t have the transport to get to a bigger shopping centre or supermarket. Similarly keeping fit is not helped by reductions in playing field availability and the reduced accessibility of leisure facilities due to funding cuts.

Section 7.3 does not consider the impact of school testing and exam pressures on children’s’ mental health, pressures that have massively increased over the last couple of decades.

Section 8.1: is this talking about Council and/or NHS employees, or working with WMCA on a wider “Thrive At Work” project for companies in the Birmingham area? It’s just not clear.

Section 8.2 lists a series of initiatives which are offered but doesn’t say if they are Council initiatives or other organisations’ initiatives. If so, it’s not clear what’s going to happen next. Column headed “What we want to achieve ” is so vague as to be meaningless.

Section 8.3 asserts that the council can reduce the stigma around metal health – how?

Section 9.1 advocates the co-production model which is now seriously being critiqued across the City – “empowerment” is too often a euphemism for “you’re on your own, do it yourself”. There’s no quantification of numbers and what resource would be needed to tackle social isolation. Social isolation should be a factor to be assessed when council and NHS authorities are considering closing local facilities and moving services to more consolidated “hubs” – these may have advantages in some ways but the distances for people without transport tend to be glossed over.

Ditto Section 9.2 – if truly local facilities are closed where will the locally available advice and signposting be found?

9.3 sounds like some sort of audit of community assets might take place but it is so vague and inconclusive, with mention of unspecified partner agencies and a hippy-dippy faith in “local communities”.

9.4 is the weakest vaguest section of the lot with no quantification at all.

Section 10 talks about working with partners but doesn’t identity the partners in most cases.

Section 10.2 says that planning decisions should consider impact assessments – yes, most certainly!

In Section 10.3 the Council doesn’t identify where it has a role or influence. If there is an unstated reference to health visitors, then there is general agreement across Birmingham that these services are being cut to the bone at present.

Section 11 hopes the Commonwealth Games can be influenced to leave a legacy of improved public health: a worthy aim but mega sports events do not have a good track record on this.

Those proposing to use profiling tools (7.3 struggling families and 9.4 vulnerable adults) should be vigilant against inbuilt cultural bias, which has been clearly identified in police profiling.

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