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We all have our heroes, those who inspire and motivate us. They may be historic or contemporary, known through books, film or via the news. Quite possibly we may have actually met or even worked alongside someone who we view as a hero. Many of us, if we think about it, will have a considerable number of heroes, and every country, city and profession provides its own candidates, though many are disputed and once established heroes can find themselves out of favour as views and understanding changes. Many of course never receive much in the way of acknowledgement or reward, quiet heroes going about their work without fanfare. Of course, the field of health improvement provides us with a rich list of famous names to choose from, Hippocrates, Jenner, Pasteur, Fleming, Snow (who I will return to), Bazalgette, Bevan. I am sure you could all add many, many more. This list is of course historic, and I want to ponder a moment on who might be celebrated as a hero in 20, 50 or 100 years.

The current Secretary of State for Health, Matt Hancock, has certainly set some ambitious, possibly heroic, targets. He has stated that by 2035 he wants people to have an additional five years of healthy, independent life. This aspiration is kept company by others: the intention to halve childhood obesity by 2030; reduce loneliness, increase early detection of cancer, improve the use of technology and better targeting of advice at key sections of the population. Few would quibble over these being worthwhile targets. However, given recent indicators of stalling, in some groups, an actual decrease in life expectancy; levels of childhood obesity (especially in deprived areas) and the pressures on our health services and local authorities Mr Hancock may well deserve a niche in our pantheon of health heroes if his goals are achieved.

Which leads me to considering how we remember and recall our health heroes. There are of course various annual awards and talks, City Health International has its own example, notably the Alison Chesney and Eddie Killoran Memorial Lecture. Alexander Fleming has a museum named after him at the hospital where he worked. Sir Edward Jenner has an impressive memorial in London’s Kensington Gardens. Aneurin Bevan, one of the founders of the NHS, is remembered by an impressive statue in the centre of Cardiff.

One of my heroes is Dr John Snow. Born in 1813 he came from humble origins and is now an iconic figure in the development of public health and epidemiology. He is particularly famous for having identified the source of a cholera epidemic near his home in Soho and persuaded the local council to render the offending water pump inoperable. This at time when miasmic theory still prevailed and nearly twenty years before Pasteur proved the link between germs and disease. Dr Snow acted based on the available evidence and driven by his determination to improve the lot of his fellow citizens.  He is very visibly remembered by a pub named after him in Soho. Ironic given he largely avoided alcohol during his life.

A contemporary of Dr Snow was William Duncan. He was born to Scottish parents in Liverpool in 1805, after qualifying as a doctor in Edinburgh he returned to Liverpool. There, in 1847, he had the distinction of being appointed as Liverpool’s first Medical Officer of Health. This was a hugely significant appointment, a first for Britain, being an indicator of how civic authorities were taking on the challenge of health improvement for their rapidly growing populations. Dr Duncan does have a building named after him at the Faculty of Medicine, Liverpool University, but is also remembered by the Dr Duncan’s pub in the centre of the city.

It is my hope that when the City Health community gather in Liverpool around the 22 March https://cityhealthinternational.org/2019/, that some of us might manage to raise a glass (non-alcohol and sugar free - if desired) to this local hero of public health, while we consider the efforts of our colleagues and ponder the challenges we face. One thing is clear to me, that if we are going to meet the needs of our populations, make things better for all our people, and who knows, even hit the targets set by our politicians, we need some fresh inspiration, new ways of working and to share our innovations and experiences. Who knows? Maybe one of the attendees will have a pub named after them for their achievements. I will drink to that.

Monday, May 27, 2019
The value of partnership approaches and joint working to tackle major health public policy issues is widely accepted, if more rarely practised. Even where there is engagement with other professions or disciplines there is a tendency to work with those whose outlook is not too challenging and are closest to us in practice and approach. City Health has been at the forefront in challenging this and others are also working to weaken the silo walls. In the last two weeks I have been a spectator and a participant in two very different events which highlighted how important it is to include the end user, the public, our communities when developing and delivering services.
Wednesday, May 15, 2019
The confidence we have in our health systems is at the core of how we use and, hopefully benefit, from them. If we lack confidence in the benefits of going to see our GP for a health check, seeing a nurse about a travel vaccination or asking advice from the local pharmacist why would we bother? In terms of dealing with drug and alcohol problems the importance of a positive therapeutic relationship or alliance is recognised not just as being a pleasant “extra” but being central to aiding recovery. It has an important role across all fields of treatment. There are also benefits where a society has faith and confidence in those that oversee and provide healthcare systems and treatments at a population level. By and large, despite many complaints and challenges, the National Health Service in the UK remains a highly valued and trusted part of our society. And rightly so. But that doesn’t mean we should shy away from acknowledging where things have gone horribly wrong.
Tuesday, April 30, 2019
In England, the Easter public holidays see many of us get a four-day weekend. Schools are on holiday, roads are jammed, airports overflowing and much of the country indulges in chocolate, either in the form of eggs or bunnies. This year we also enjoyed some great weather. Fortunately, May looms, which brings another two holidays for us to recover from previous holiday excesses/hard work (delete as appropriate).
Thursday, April 11, 2019
Let me start with a big thank you to Liverpool, and especially the team from John Moores University, for another outstanding City Health conference. The impressive surroundings of Liverpool Medical Institute- a monument to the 19 th century’s commitment to science as well as its obsession with ancient Greece- proved to be an ideal venue. It contains a wonderful historic library, a selection of surgical and medical tools that bring a tear to the eye, and portraits of those who have contributed to the development of public health and modern health care, including some rather fearsome looking characters.

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CITY HEALTH INTERNATIONAL EVENTS

CHI Melbourne 2019

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CHI Liverpool 2019

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CHI Odessa 2018

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CHI Basel 2017

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CHI London 2016

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CHI Barcelona 2015

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CHI Amsterdam 2014

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CHI Glasgow 2013

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CHI London 2012

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City Health International
Founded in 2012 City Health International is a network of individuals and organisations engaged in the study of and response to structural health issues and health behaviours in the urban environment.
For the first time in history the majority of the world’s population now live in urban environments and the proportion continues to grow. As national governments struggle to deal with the pressures and demands of growing urban populations against a backdrop of financial deficits and uncertainty, it is increasingly left to those working at a city level to provide the leadership and support needed to tackle key health issues.