An enduring memory from my time as a Public Health Registrar was the Director of my local Health Protection Agency telling me (during a particularly interesting and high profile outbreak) that Public Health was the arena where “medicine meets politics.” At the time, I thought that he was mainly referring to the fact that he was getting phone calls every 5 minutes from local politicians wanting assurances that this outbreak was under control, and that the very successful and globally renowned local business would not be shut down permanently. But in hindsight, as my career has taken me increasingly in to the political arena, I have begun to appreciate just how much of my work as a public health professional overlaps with the world of politics.
My involvement in all things Political began fortuitously as my love of working in a Local Authority declined. I have never been very good at keeping opinions to myself, and the move from an NHS training programme (where I was generally allowed to argue my case, and decisions were more often than not made on available evidence) into a Consultant post in a Local Authority (where the arguments I made were filtered through Political persuasion) was always going to be tricky. I worked with a great Public Health team in the County Council, many of whom had weathered the Political arena for some years already and were far wiser than me when it came to working with our allocated Cabinet Member. Our Cabinet Member was also well seasoned and knew what she wanted and how she wanted it – I frequently disagreed, both from a Political (ideological) standpoint and from the available evidence base. When the 2015 election saw another defeat for my Political Party of choice, I threw in the officer towel (continuing to be very grateful to all colleagues who stayed the course!) and decided to play to my opinionated strengths. I became active in my local Labour party, and in 2017 was elected as the first Labour Councillor on Worthing Borough Council for 41 years.
In Politics, one of the first things I learned is that our evidence base in Public Health will only get you so far. The arguments that you make to achieve your goals are as much about the relevance to your audience and the zeitgeist of the day, as they are about what the data tell us. I am eternally grateful for my instructions in the art of reading statistics (lies, damned lies etc.), but I have had to learn that my local constituents need to know what that statistic will mean for their family, not a thousand families. Our understanding of the wider determinants of health (I am constantly recommending anything written by Sir Michael Marmot to any colleague who will listen) is one of the areas that I treasure most from my training and work in both the NHS and Local Authorities, but there is nothing quite like sitting with a local family who are about to go in to emergency accommodation because they cannot find any affordable housing in the area, to nail the lesson that a home is at the heart of a human’s wellbeing.
In our area, as with most of the UK, we have seen an increasing use of foodbanks as austerity and the introduction of Universal Credit have cut people’s ability to provide for themselves and their families. A National Government has enforced austerity for 10 years now, leaving Local Government finances at an all-time low. In spite of the frequent soundbites from Government benches that the deep cuts to the public purse were absolutely necessary, there are numerous economists who have argued that this drastic response to the financial crisis was unnecessary and has penalized the poorest in our society for the problems of our deregulated financial system.
Local Authorities like mine, now find themselves in a bind. The pairing down of the State might fit with the councils ideology, but the reality on the ground is that we are hugely under-resourced and failing to provide adequate social care, education, public health, housing, waste management, or transport infrastructure. As a Public Health Consultant, seeing on a daily basis in my local area what this Political ideology has taken from our population’s health and wellbeing, I find that the translation of our statistics, reports and research is more pressing and relevant than ever. Public Health needs a strong voice in the Political arena, and it is my privilege to be one of those voices.