Episode 7: Advancing Public Health in Local Government with Greg Fell

Money Power Health with Nason Maani

Hello everyone and welcome back to Money Power Health.

As we have been discussing in previous episodes, health is to a large degree shaped by our social and physical environments. Public Health, as defined by Acheson, is “the science and art of promoting health, preventing disease, and prolonging life through the organized efforts of society.” Some of that art and science, in fact a lot of it, plays out at the level of local, rather than national government.

In the UK, local authorities have statutory public health responsibilities carried out by teams of local public health professionals, led by a Director of Public Health. Directors of public health are responsible for determining the overall vision and objectives for public health in a local area.

What’s so fascinating to me about public health in local authority settings is that it is at the coalface. DPHs and their teams have to work alongside a range of other local stakeholders and elected councillors who change over time. For many of them, health might be a secondary concern, or not even something they consider themselves affecting. The skills they apply in doing this, are unique, but incredibly important for many of us who care about money, power and health.

This week we are talking about the practice of public health in local authorities, with Greg Fell. Greg Fell is the Director of Public Health in Sheffield, and Vice President of the Association of Directors of Public Health (ADPH). During the COVID-19 pandemic, DPHs like Greg and their teams faced enormous pressures in terms of their capacity, coordination, expertise and media presence. He is a leading voice in UK public health, and has an excellent blog where he pulls together a wide range of knowledge into bite-size, actionable chunks.

In this podcast we cover Gregs journey into Public Health, what a Director of Public Health does, the state of health and health inequalities in Sheffield, what it was like working in a public health team during COVID-19, how to think pragmatically while mindful of the wider forces that shape health, what brings satisfaction in work of this type, what personal qualities one needs to be effective in that kind of local government setting, and what commercial determinants of health mean for public health at the local authority level. Huge thanks to Greg for sharing his candid reflections, he is a fountain of information.

Link to Gregs blog: https://gregfellpublichealth.wordpress.com

Link to ADPH website: https://www.adph.org.uk

Link to the article on the pollution of discourse he mentioned: https://www.bmj.com/content/377/bmj.o1128.long

Link to the Health Foundation’s excellent report on framing and health: https://www.health.org.uk/publications/a-matter-of-life-or-death

Link to the citizens advice bureau he mentioned: https://www.nhs.uk/services/service-directory/sheffield-citizens-advice-bureau/N10977109

Link to Daniel Maani’s music: https://youtalktoomuch.band