How closely do the public priorities match that of the new health and wellbeing boards? “Not very” is the worrying answer.
To get to this answer, we first looked at what the general public would identify as public health concerns. A recent populus poll commissioned by Open Road asked over 4000 people to select the top three priorities for public health funding to be allocated to in their area. The results are below with the top three priorities for the public being cancer prevention, tackling drug use and increasing physical activity.
We then took a look at what the emerging priorities for a sample of 20 Health and Wellbeing Boards in the Joint Health and Wellbeing Strategies. The three priorities mentioned the most were reduction of health inequalities, promotion of healthy lifestyles and preventive care.
Of course the priorities of the public and those of the new structures are not mutually exclusive but one can see that there will be quite significant mismatches going forward. For example tackling drug use or a specific focus on cancer prevention might not be at the very top of a long list for HWBs. Likewise tackling mental health problems and reduction of health inequalities might not enter the public’s considerations.
Such mismatches will require a careful strategy for public engagement if the public are to support the implementation of these strategies and vote for the politicians that suggested them (and spent taxpayers’ money executing them). Although there is already an increasing recognition that the public must be involved in the new public health agenda, co-production of health outcomes is going to be very challenging. In many cases a consultation on the strategy is going to be insufficient in getting buy-in. A survey of those involved in the local health and wellbeing agenda, as part of a recent research report Healthy Places, found that actual engagement with the public lagged behind the ambition and that the best intentions are yet to be realised.
Aligning the public’s views of local issues and the public health problems identified through the Joint Strategic Needs Assessments is going to require a new type of political leadership. One that goes beyond preventing hospital closures and finds new ways of shifting the debate as well as the use of taxpayers’ money to prevention and the wellbeing of the local community as a whole.