Making a reality of wider ph in lg 7th march (david hunter)

Centre for Public, Policy & Health

Making a Reality of the Wider Public Health in Local Government

Presented by David HunterProfessor of Health Policy & ManagementTuesday 7th March 2017

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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

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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

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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’

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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

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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

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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

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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

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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

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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

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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

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Jazz as a Metaphor for System Leadership

Making a reality of wider ph in lg 7th march (david hunter)

Healthcare

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