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Signs of good times ahead

With a public commitment from the Department of Health to improve the roles of community health professionals and a promise for more investment, nothing but success lies ahead for primary care. Lynn Young is optimistic about the future …

Lynn Young
Primary Healthcare Adviser for the RCN

It is a particular pleasure to write this column as I am able to report on the most positive health event I have attended for many a year. On 15 May the Department of Health (DH) held a primary and community strategy day, which was attended by a glorious mix of nurses and allied health professionals. What a jolly day it was for all concerned!

Over the years it has been an enormous struggle to ensure that the community nurse voice is heard in the corridors of power. After all, what do health ministers, senior civil servants and chief executives understand about the power and glory of spectacular community nursing services, such as health visiting, district and community mental health nursing? The trouble is that we as mere human beings have little grasp of events and issues, without experience. What use, after all, are pompous views from people who indulge in having strong opinions about everything - including those things that they have little personal experience of?

We continue to struggle to talk about the importance of robust health visiting services and the elegance of receiving brilliant nursing while ill and increasingly, thankfully, dying at home. But, being a pathologically optimistic creature I listened to what was sublime music to my ears. Mark Britnell, current director general of commissioning and system management at the Department of Health, spoke of his magical visit to Liverpool when he experienced the sheer energy, commitment and brilliance of the community nurses. Well done to our community heroes and heroines who continue to ease the troubled lives of the good people of Liverpool - the birthplace of district nursing.

I have been around long enough to realise that words are easy and the right action more difficult to achieve. But Mark Britnell made a public commitment to call for the improved roles of community nurses and allied health professionals, and for more strong leadership, liberation and autonomy for these good people who, for the main part, currently work in primary care trusts.

More investment is promised for community health services in the future as we approach the time that the recommendations made by Lord Darzi will with the long journey towards implementation.

Perhaps the best news from the DH is that no further major reorganisation is planned for the foreseeable future, thus allowing energy and focus of attention to be given to developing more and better community-based care.

A DH community and primary care transformation board is to be set up, and a sense of momentum gathered to rapidly and significantly improve public health measures and services, which will enhance health and prevent hospital admission.

Us primary care groupies are on a mission to prevent the preventable and to identify disease at the earliest possible opportunity. We have to become smarter at both prediction and prevention if the UK is not to become the sick nation of Europe. So much effort from all agencies, sectors and government departments must be thrown at the whole scale removal of fat.
Yes readers, we can no longer hedge the terrible problems we face if we are not effective at reducing our shameful record and incidence of obesity. Obesity kills and it makes our young sick, with a poor quality of life. The truth is that we now know that obesity is linked to a whole range of diseases, including cancer. Call me a health fascist if you like, but our young folk are destined to die younger then their parents if we fail as a nation to attract them to a life of leanness and activity.

Many of you, with justification, may feel a little cynical at the news of a refreshed attempt to have a national health service with primary care at its centre rather than the hospital. But I feel cheerful enough to believe, once more, that we may be heading for a Darzi-type NHS, which ensures that the community receives a far larger slice of the cake than it has ever enjoyed in previous times.