Shirley Cramer CBE, Chief Executive of RSPH

Shirley Cramer CBE, Chief Executive of RSPH, relates the highlights from Simon Stevens' presentation at the Public Health England Conference on 17 September 2014.

The moment we have long awaited came at approximately 3:30pm on Wednesday, 17 September at the Public Health England conference on the campus of Warwick University. It was an auspicious occasion as Simon Stevens’ public appearances have tended to be, not least because his comments move far beyond the usual platitudes to some statements you hoped he would make but never dared hope.

He pointed out that it was the end of a long day for many weary conference attendees and was grateful that people had stayed to hear him. But of course he was a star attraction and the chance for the public health community to question the head of the NHS in England was far too good to be missed.

He talked about his aspirations for health and wellbeing which are reflected in a new ‘5 Year Forward Look’ which he intimated was due to be published shortly. He called for a ‘radical upgrade in public health’ which was music to the ears of the audience of public health professionals. He illustrated his views by stating that it is ‘bizarre’ that we are spending more on bariatric surgery than we are on the prevention of diabetes.

He pointed out that the evidence base for prevention was clear and compelling and that proven interventions give a 58% reduction rate from pre-diabetes to diabetes. Which of course prompts the question, so why aren’t we doing anything about it?

He told us that it was about leadership, and that between NHS and PHE they intended to make the decisions that would roll out these interventions around prevention ‘ at scale’ . Instead of working in silos, there will be joined up decision making and real leadership. Duncan Selbie was beaming so I took this to be an excellent sign of things to come.

With obesity as the main enemy, he moved on swiftly to castigate the lunch choices of his young advisor, who had to rush into WH Smith at Euston Station to purchase food. He illustrated the unhealthy nature of the WH Smith offering by showing us the empty sandwich pack (cheese and onion on white), crisps, a fruit flavoured drink, chocolate and fruity sweets. He described this as a form of ‘health pollution’.  

So there you have it. Change is in the air.

 He told us that the ‘NHS was not a national role model for healthy workplaces’ and despite the fact that numerous reports have highlighted this point, too little has been done about it. He wants the NHS to be a better employer and offer healthy choices for food and dietary advice. As a member of the Hospital Food Standards Panel that recently made recommendations to the Government about hospital food for patients, staff and visitors, this priority was especially welcome.

With a nod to the Scots, he announced that public health should be ‘devo max’ with decisions made locally so that they could go ‘further and faster’ . He cited former Mayor Bloomberg of New York as an example of good local decision making that had eventually effected national discussion.

So we heard what we have been waiting for in public health, ‘follow the evidence, act on it and do good interventions at scale’. It sound like we could be living in exciting times!