Report of the Director of Public Health

This report provides the Committee with an update on the work of the Making Manchester Fairer Task Group.

The Committee considered the report of the Director of Public Health that provided an update on the work of the Making Manchester Fairer Task Group.

Key points and themes in the report included:

·         Making Manchester Fairer 2022-27 described the actions that the city would take to reduce inequalities, with a focus on the social determinants of health;

·         The Making Manchester Fairer Action Plan would be launched for staff within the wider population health system at The Making Manchester Fairer Conference on Monday 31 October 2022;

·         The final version would be accompanied by a communications campaign;

·         Providing a summary of themes, plans and key actions;

·         Information on the Kickstarters, four schemes that could be implemented quickly to give the plan momentum;

·         Information on the Making Manchester Fairer Task Group and Network, noting that they would have oversight of the collective development and delivery of the plan;

·         The agreed mechanism to undertake the evaluation and monitoring of the plan;

·         The approach to workforce engagement;

·         The approach to resident and community involvement; and

·         Providing a selection of case studies.

Some of the key points that arose from the Committee’s discussions were: -

·         Welcoming the report and recognising the important work that was being delivered on behalf of the residents of the city to address health inequalities;

·         Condemning the Government for failing to address health inequalities;

·         Calling for a coalition of voices, hosted in Manchester to challenge the Secretary of State for Health and Social Care on this issue;

·         Noting that in New Zealand, the Prime Minister had challenged all policy makers to address health and wellbeing in all their decision making;

·         Welcoming the inclusion of businesses in the work to address health inequalities and recognising the relationship between good employment and health outcomes; and

·         Noting the good work provided by the Voluntary Community and Social Enterprise sector, however noting that they would need to be supported to change and adapt to the cost-of-living crisis.

The Committee heard from Professor Sir Michael Marmot, Institute of Health Equity. He reiterated the stark health outcomes and inequalities experienced by Manchester residents and how Covid had exacerbated and further highlighted these. He stated that health inequalities had been subject to three significant factors, namely austerity, the pandemic and now the cost-of-living crisis. He stated that currently there was no indication from government that they were seeking to address health inequalities and were following ideological economic policies rather than the overwhelming evidence, adding that this was ultimately dangerous for the health of the population.

Professor Sir Michael Marmot commented on the progress and approach adopted in Manchester adding that this experience was used as an exemplar model, and that other regions, particularly in the North East were keen to develop similar plans to address health inequalities. He said that as more regions adopted this evidence-based model it would provide leverage to persuade the government to engage seriously on this issue. He stated that he would support the call for a coalition of voices that brought together all partners and different regions to then invite the Secretary of State for Health and Social Care to listen to the case for addressing health inequalities. He suggested this could involve the Mayor of Greater Manchester and the Universities.

Professor Sir Michael Marmot welcomed the insightful contribution from the Deputy Director of Public Health to recent discussions at an Advisory Board on the issue of structural racism. He stated that this Board had provided a clear steer for the need for a detailed understanding of this issue, and the importance of doing this ‘with’ communities affected by racism.

In response to comments raised by a Member in regard to health inequalities experienced by older residents, he acknowledged this and stated that he fully supported any activity to address this. He commented that it was evidenced that social isolation was as harmful to health outcomes as smoking cigarettes. In response to a Member’s comment regarding the impact of damp homes on people’s health, particularly respiratory conditions, Professor Sir Michael Marmot stated that this was understood. He added that the Institute of Health Equity had recently published a report entitled ‘Fuel Poverty, Cold Homes and Health Inequalities in the UK’.

Professor Sir Michael Marmot advised that the Health Equity Network had recently been launched that had been hosted by the University of Manchester. He described that this network sought to bring businesses, in partnership with the Public Sector, Health and the Voluntary Community and Social Enterprise sector into the discussion and actions to address health inequalities. He stated that the three domains that the Network would consider were in relation to Good Employment, including pay and conditions; Goods and Services and the impact of Anchor Institutions. He stated that Legal & General had joined the Health Equity Network which was a very positive development. He advised that the work and outcomes of this network would be assessed and reported.

The Deputy Director of Public Health discussed the importance of tackling structural discrimination and racism. She stated that this could only be achieved through meaningful commitment, collaboration and coordination across all systems. She reiterated the importance of involving all communities and all voices, noting that this would include those that were traditionally regarded as being overtly challenging or difficult. She stated that it was recognised that a ‘one size fits all’ approach was not appropriate and bespoke and appropriate engagement would be required. She stated that it was important to establish trusted relationships and dialogue with communities acknowledging their lived experience of racism. She said these conversations and listening would be assisted by connecting through trusted community networks and neighbourhood teams, using a Community Development approach. She stated this would build on the lessons learnt from the Winning Hearts and Minds activities and the work of Covid Health Equity Manchester that arose in response to the pandemic. The Director of Public Health commented that the lessons learnt and experience of delivering the vaccination programme would also help inform this approach to community engagement.

The Deputy Director of Public Health acknowledged the comment raised regarding older people and advised that the final plan would include a specific element regarding the life course, that included older people.

The Director of Public Health advised that the Plan was a system wide plan that involved all Council Departments, including housing.

The Executive Member for Healthy Manchester and Adult Social Care paid tribute to the Director and the Deputy Director of Public Health and all staff involved in producing the report. He further welcomed the Members’ ongoing challenge and scrutiny of this important area of work. He further commented that GP’s were now included as members of the Provider Collaborative Board and the issue of fair work was included on the Board’s agenda for discussion. He stated that addressing health inequalities was central to the work of health and social care integration in Manchester. He further paid tribute and appreciation to Professor Sir Michael Marmot for his continued support and contribution to the work of the city.

The Chair in closing this item of business thanked Professor Sir Michael Marmot for his continued support for the work being progressed in Manchester and for attending the meeting. She further thanked the Director of Public Health, the Deputy Director of Public Health and all staff involved in this work. She further stated that she would be attending the Making Manchester Fairer Conference on Monday 31 October 2022.

Decision

The Committee recommend that the Executive Member for Healthy Manchester and Adult Social Care organise a coalition of voices event, hosted in Manchester by the Mayor of Greater Manchester to invite and challenge the Secretary of State for Health and Social Care on the issue of health inequalities.