Speaker session 1 (key note) • Speaker 1: Professor David Hunter, Director of the Centre for Public Policy and Health, Durham University Title ‘Making a Reality of the Wider Public Health in Local Government’

1. Centre for Public, Policy & Health
Making a Reality of the Wider
Public Health in Local
Government
Presented by David Hunter
Professor of Health Policy & Management
Tuesday 7th March 2017

2. ∂
Centre for Public Policy & Health
Welcome Return of Public Health
to Local Government
 Context conducive to wider conception of
heath – not just about health care
 Marmot City – all relevant organisations
commit to work together

3. ∂
Centre for Public Policy & Health
Focus on Embedding Marmot Six
 Giving every child the best start in life
 Enabling all children, young people
and adults to maximise their capabilities
and have control over their lives
 Creating fair employment and good work for all
 Ensuring a healthy standard of living for all
 Creating and developing healthy
places and communities
 Strengthening the role and impact of preventing
ill health

4. ∂
Centre for Public Policy & Health
New World of Health and Wellbeing:
People and Place-shaping
 Health in All Policies (HiAP)
 Influencing the wider determinants of health
 Whole-of-government and whole-of-society
approaches
 Importance of whole system leadership and
‘soft power’

5. ∂
Centre for Public Policy & Health

6. ∂
Centre for Public Policy & Health
What is HiAP?
 About governance/policy ideas based on
collaboration, partnership, structured
interaction and ongoing relationships
 Needs to be integrated with other cross-
cutting policy interests such as equity,
sustainability and demography
 About creating places (physical and social
environment) which support and generate
good health

7. ∂
Centre for Public Policy & Health

8. ∂
Centre for Public Policy & Health
Why is HiAP Needed?
 To meet challenge of ‘wicked problems’
 To break down ‘siloed’ nature of government,
nationally and locally
 To promote intersectoral collaboration
 To share resources and reduce
duplication at a time of austerity

9. ∂
Centre for Public Policy & Health
Why is HiAP Difficult to Implement?
 Lack of institutional support
 Ineffective leadership
 Poorly planned or unclear objectives and
responsibilities
 Hostile stakeholders
 Weak enforcement
 Limited resources and capacity
 Unrealistic time frames

10. ∂
Centre for Public Policy & Health

11. ∂
Centre for Public Policy & Health
Examples of Fire Service's Wider
Public Health Role under MECC
 Helping support people with dementia
 Firefighters to be 'health champions'
 Tackling child obesity
 Reaching out to the most vulnerable
 Looking out for babies and toddlers
 Getting people active
 Working with others to save lives
 Reducing falls in the home

12. ∂
Centre for Public Policy & Health
Lessons from Research on
Partnerships
 Policies and procedures need to be more streamlined –
focus on outcomes not process and structure
 Partnerships in practice can be rather messy constructs
 Tendency to over-engineer partnerships, often to the
exclusion of being clear about purpose and
achievement
 Structures are less important than relational factors
such as trust and goodwill
 Importance of leadership styles – collaborative,
integrative and adaptive

13. ∂
Centre for Public Policy & Health
The Challenge of System
Leadership
 Limits of top-down, command and control
leadership
 Leadership is shared,
distributed, engaged,
adaptive
 Core characteristics:
building alliances, persuasion,
influence, political astuteness
 Different set of skills and behaviours required

14. ∂
Centre for Public Policy & Health
Rethinking Leadership
 Old notions of leadership as dynamic, decisive, authoritarian and
competitive are not well suited to complex environments
 System leadership requires well-developed skills of negotiation and
consultation to enable collaborative direction-setting and decision-
making with other stakeholders
 Good leadership is not only about the individual qualities of the leader
but also about enabling the whole system to be supportive of
innovation, an awareness and understanding of complexity and an
appreciation of the perspectives of different stakeholders
 Successful leaders
understand complex
adaptive systems
and culture

15. ∂
Centre for Public Policy & Health
Jazz as a Metaphor for System
Leadership