Agenda item

Councillors Bright and Butt arrived during this item.

Fiona Wright, Consultant in Public Health Medicine, LBBD, presented the report, which also acted as an introduction to the interactive workshop session that was undertaken during the Board meeting. 

Fiona explained that the Mayor of London’s aim was to reduce unfair health equalities across London and the consultation period was underway on his draft strategy, which sets out five key aims for reducing health inequalities in London by 2027, namely Healthy Children, Healthy Minds, Healthy Places, Healthy Communities and Healthy Habits.  The deadline for responses to the Mayor was 30 November 2017. 

The Board was reminded of the recently published Borough Manifesto, the statutory background, other local plans including, the key ambitions of the Joint Health and Wellbeing Strategy and Joint Strategic Needs Assessment (JSNA), which were due to be refreshed, and sub-regional and demographic changes that were occurring.  There was now an opportunity to look afresh at what could be achieved across London and in the Borough with the help of the Mayor.  Fiona drew specific attention to the areas where the Borough was rating poorly including, child obesity, the proportion of people with mental illness in settled accommodation, deprivation and employment levels, more than 50% of households in 4 out of 17 wards have deficient access to nature, high levels of criminal notifiable offences and their impact on health and wellbeing, and high smoking rates particularly in pregnant women.  However, there would also be an opportunity to promote areas of good practice within the Borough in the response to the Mayor.

In response to a question from Cllr Carpenter, LBBD Cabinet Member for Educational Attainment and School Improvement, regarding early years actions, Anne Bristow, LBBD Deputy Chief Executive & Strategic Director for Service Development and Integration, said that she felt that we needed to look at more than just physical health and should investigate putting actions and interventions in place before birth.  For example, we need to look at using antenatal classes for more than physical care skills, such as how to bath a baby, and also use them to teach parents about emotional needs such as how to talk to their baby.  Ian Tompkins, Director of Communications & Engagement, East London Health & Care Partnership, commented that education on good health choices and health risks is important, however, we need to look at why people continue their bad practices when they know the consequences.  Cllr Turner LBBD Cabinet Member for Corporate Performance and Delivery, commented on the lack of reference to what is in the Mayor’s powers, where he could specifically make changes, for example there was no mention of public transport.  Cllr Turner drew the Board’s attention to the aims set out on pages 23 and 24 and also questioned why some diseases were targeted but not others.  The Chair raised several issues including, the potential to use Town Planning as a tool for change, funding and parity of provision. 

The Board:

(i)  Having considered the draft Mayor of London’s Health Inequality Strategy and discussed the London wide and local implications following an interactive workshop, the Board endorsed the principle behind the five aims set out in the Strategy.  However, the members of the Board raised a number of issues to be included in the response, these issues are outlined below:

(a)  The draft Strategy was too general in places.  Members of the Board felt the aims should be more targeted and should set out with more detail what the intentions and results are, this will allow the correct interventions to be put into place locally, for example:

·  Needed to have more specific targets for cross London interventions, e.g. the Mayor should set an air pollution level for all London Boroughs.

·  Specify what was within the Mayor’s power to affect change, rather than what his office can influence, for example there is no mention of public transport and how the Mayor’s powers could be used on the advertising of unhealthy foods and drink on TfL transport and premises.

·  Why was Tuberculosis and HIV/Aids specifically raised, but not other diseases.

·  Transitory nature of our local population, which moves across borough boundaries.

·  The need for consistent messages and support levels across all partners regardless of where you are in the borough, sub regional or London area. 

·  Use of the Air Toxicity Tax to benefit all of London, not just the more affluent boroughs in central London.

·  Encourage a ‘children welcome here’ ethos in businesses and public bodies.

·  Encourage the ‘daily mile’ in all schools across London.

·  History shows that residents in affluent areas have benefited more from health interventions and programmes than the more deprived areas of London and what support was being offered to address this.

(b)  Suggested that initiatives, such as bicycle hire, are not concentrated in central London but are expanded to the outer London boroughs.

(ii)  Delegated authority to the Deputy Chief Executive and Strategic Director for Service Development and Integration, to sign-off a detailed consultation response, based upon the feedback from the workshop session, on behalf of the Council in consultation with the Chair, Director of Law and Governance and the Director of Public Health;

(iii)  Encouraged partners to submit consultation responses and noted that ELHCP would also be including in their response many of the same points raised by the Board; and

(iv)  Agreed that the Mayor’s final Strategy will be reviewed to inform the refresh of the Barking and Dagenham Joint Health and Wellbeing Strategy in 2018.