With responsibility (and a £5.45 billion budget over 2 years) for public health moving to Local Authorities from April 2013, I thought it timely to shine a spot-light on the chief executive of Public Health England.
Recent profiles of Duncan Selbie, chief executive of Public Health England, paint a picture of a modest, disarming leader, with a common touch that has been developed through a non-traditional rise up the NHS leadership ladder. Mr Selbie is not from the traditional medical or academic background that is common-place among his peers. It might be this practical nature that has allowed him to establish a track record of implementing change that is based on the reality faced by his patients and employees.
He understands that public health is related to other equality factors; that education, housing, age and social interaction can have a determinable affect on someone’s health. This understanding is good news and should encourage a joined-up approach by Local Authorities, community groups and health organisations to tackle public health issues.
However, what does he think about behaviour change and social marketing in relation to public health? To my knowledge he has not been probed directly about it, but a recent article I read in The Times might provide some information; in it Mr Selbie comments:
“I cannot be a super-nanny. Telling people what to do, directing them and ordering them, writing strategies and putting together toolkits are a complete waste of time. You create an environment where people feel able to do the best they can, to run towards problems and not be afraid.”
He’s right (partially). No one wants to be told what to do, but creating this ‘environment where people feel able to do the best they can’ is a big challenge. Let’s take the example of cancer awareness. Simply supplying people with information on what to look for and then telling them where to go assumes that they will act on a rational basis. This is, of course, incorrect. People can know what to do and still not do it. Information must be framed in a way that resonates with the target audience – this requires insight, targeted interventions, appropriate reassurance and timely reminders.
You’re never going to create a society where people consciously ‘run towards problems’. It’s within human nature to make things as easy as possible for ourselves; it’s hard-wired into our brains to help us process a deluge of daily information. However through incorporating social marketing techniques you can look to dilute the problem and provide easy, simple steps for people to resolve it.
With such a big change occurring in the public health landscape, my advice for Mr Selbie is to encourage Local Authorities to first of all understand the barriers local residents face in trying to lead a healthy life. After all, we want to ensure Local Authorities don’t run before they can walk.