Breaking down the silos

Breaking down systemic silos is key to tackling health inequalities, an event run by The King’s Fund has heard.

Dame Rachel de Souza and Sarah Woolnough (c) The King's Fund

Dame Rachel de Souza and Sarah Woolnough (c) The King's Fund

Speakers at the Tackling health equalities event argued that only by removing barriers across Government and political parties, as well as between central and local government and local services, can wrap around services be effectively provided for the individual.

Government silos

Joe Farrington-Douglas, senior fellow, Health Equals, said Labour had failed to ‘deliver the cross-Government prevention mission we had hoped'.

He said: ‘We need to get back to the idea of a whole society mission for healthcare.'

Children's Commissioner for England, Dame Rachel de Souza, said: ‘When I started my biggest shock was how siloed Government was. Our systems don't work properly. It's a kind of madness. I sit with health ministers and I sit with education ministers and each of them blames the other.'

Neighbourhood health

Dr Minal Bakhai, former head of the National Neighbourhood Health Implementation Programme, said a cross-Government and cross-service approach was essential to delivering neighbourhood health.

Rich Brady, director, strategy and partnerships, Nottingham City Place-Based Partnership, agreed, commenting: ‘The challenge for neighbourhood health is about abolishing segmentation.'

Strategic authorities

Katherine Merrifield, deputy director, Healthy Lives, The Health Foundation, said strategic authorities offered a real opportunity to embed health in all policies.

Merrifield said: ‘There's something quite special about how strategic authorities can act.'

Vicky Hobart, public health group director for the Greater London Authority, agreed, highlighting how the London Mayor supported health in all policies.

Lessons from the UK and elsewhere

Looking at international lessons and innovations, Dr Sumina Azam, national director of policy and international health, Public Health Wales, welcomed the in-coming Welsh Government's plans to introduce a cross-department minister for public health.

Paul Johnston, chief executive, Public Health Scotland, highlighted how Scotland's interventions on public health extended way beyond the NHS, including weekly child poverty payments.

He said Scotland's long-term health policy included a shared approach between national and local government that crossed departments and political divides to provide a whole system approach.

Monika Kosinska, global lead, health equity and social determinants, WHO, said the countries making the greatest approach internationally, such as Norway, New Zealand and Iceland, were also taking a cross-Government approach.

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