To consider the Director of Public Health’s Annual Report 2003.

The Committee considered the Director of Public Health’s Annual Report for 2003.

Dr. Mike Deakin, Director of Public Health (DPH) for Herefordshire, informed the Committee that as Director he was statutorily required to produce an independent Annual Report on health in Herefordshire.  The report commented on health issues in the County and made a series of recommendations designed to generate improvements.

Dr. Kathryn Millard, Consultant in Public Health for Herefordshire Primary Care Trust (PCT), gave a presentation on the Annual Report.  She informed the Committee that the Annual Reports were designed to be read as an ongoing series reporting on health issues in Herefordshire.  The reports did not feature every topic each year and she explained the main issues in each chapter of the 2003 report.

During the discussion the following principal points were made:

·         Dr. Deakin explained that whilst the report was submitted to Government the intention was that the messages contained within it would be read and acted upon by the public.  It was suggested to him that the document might be made more accessible if an executive summary was produced.

·         The statistics presented in the DPH Annual Report could not be used to assess health improvements year on year and it was not a progress report in that sense.  The only way to observe improvements in health was over an extended period of time.  For example, the 2001 DPH Annual Report contained a 40-year historical review which showed the significant improvements in life expectancy and decline in child mortality rates.  Chapter 1 provided a review of the recommendations in the previous 3 Annual Reports.

·         It was noted obesity was high on the health agenda and was set to feature in a specific chapter in next years DPH Annual Report.

·         It was noted that a number of services were no longer provided by the Council.  Leisure Services were, for example, provided by HALO.  Dr. Deakin confirmed that mechanisms were in place to ensure health messages reached such bodies.

·         It was noted that with the ever increasing cost of health services, improving public health and reducing the call on those services was an important objective.  Dr. Deakin acknowledged that more resources would be beneficial noting how Herefordshire had spent more on reducing smoking than any other PCT in the region and had a success rate way above the average.

·         Dr. Deakin felt that his recommendations did have an impact and cited examples of his previous Annual reports being quoted by others when the need for service improvement was being discussed.  Articles had also appeared in the Hereford Times publicising the key issues.

·         Members noted that a person would only have to cease from smoking cigarettes for four weeks to be recorded as a non-smoker in NHS statistics.  The Committee felt that this target was too low as a person who had registered as a non-smoker could have resumed smoking after this short period.  Dr. Deakin informed Members that this was a nationally set target which was practical to work with; it was also significant because 50% of smokers who had given up for 4 weeks would never smoke again.

·         One of the report’s recommendations was that there should be a specialist stroke unit in Herefordshire.  Dr. Deakin explained that Herefordshire had an excellent Stroke Service but the evidence was that a dedicated specialist facility could provide an even better service.  Members suggested that as the County’s population contained a comparatively higher proportion of older people it might be worth considering whether a Stroke Unit in Herefordshire could be developed as a specialist centre of excellence.  It was noted that the provision of a Stroke Unit would also have a significant benefit in relieving pressure on social care services.

·         The Health Promotion Team provided advice and training to particular people (teachers, new nurses etc) so they could disseminate their knowledge to those for whom they were responsible.  The Resource Centre in Blackfriars Street made available a wide range of resources but was not perhaps situated in the most convenient and accessible of locations.

·         Only Herefordshire residents’ deaths were reported in the Road Traffic Accident statistics.  The figures represented in the statistics were therefore artificially low.

·         Dr. Deakin advised that, alongside smoking, the take up of the MMR vaccine was a particular concern.  Parents were encouraged to arrange for their children to have the combined MMR vaccinations.  GPs were endeavouring to encourage greater take up of the vaccinations.  Dr. Deakin believed that whatever steps could be taken to improve take up were being taken.  However, parents could not be compelled to have children immunised.

·         It was noted that rates of skin cancer were an issue in the County.  Dr. Deakin commented that there was clear evidence that exposure to the sun was a risk.  There were also concerns about the increase in mosquitoes and the associated diseases that they could bring with them.

·         Binge drinking was recognised as a health problem and a burden on the health service through alcohol related injuries.

·         Associated problems linked to smoking and alcohol abuse could be minimised by tougher enforcement of legal age limits.

·         Whilst there was a good coronary care programme it was not appropriate to perform heart surgery in Herefordshire, as there were insufficient patients to enable doctors to maintain the high level of expertise required.  The necessary specialist follow up care was also unavailable.

·         Herefordshire Ambulance Trust was highly rated and recognised as being outstanding when dealing with coronary cases.

·         It was noted that the Annual Report was externally audited. Dr. Millard commented the external audits had indicated that the Annual Reports were good.  Dr. Andrew Richardson of the Strategic Health Authority had audited the DPH Annual Report 2003.

RESOLVED:   That the Annual Report of the Director of Public Health 2003 be noted.