Public Health Essentials
One of the complaints people make about Public Health is that every public health professional seems to describe it in a different way when asked. This is necessarily so, to a degree. The Director of Public Health or a Consultant in Public Health in an inner city is likely to have a different set of priorities and problems than doing a job with the same title in a West Country rural population. We need people to understand that public health is a type of professional practice that is adaptive and is practised differently in different contexts. However the criticism has some substance too. If you were to ask twenty public health professionals to write down what they meant by ‘deprivation’ or ‘well being’ or the difference between ‘quality’ and ‘value’ then, at present, you would get very different results. Similarly if you were to ask people what the ten most important texts that they studied training you would get different results.
What we need to do in the creation of a common culture is to agree a common language and a common set of concepts. Just as cardiologists have a common concept of what is meant by heart failure and psychiatrists of bipolar disorder so too do we need a set of concepts relating to equity or well-being or quality assurance. This does not mean uniformity; cardiologists disagree about the management of chronic chest pain and psychiatrists of course disagree significantly about both the nature of the problem they tackle and the appropriateness of different interventions but these disciplines do have a common language and set of concepts.
The Public Health Essentials project seeks to identify those terms which we should use the same meaning wherever we are working. This can be difficult because of a widely used term such as value often has more than one meaning so we will have to reach agreement as to which meaning is the most useful meaning for us to have throughout the Network of Public Health Organisations. In identifying common concepts it is appropriate to use key texts from which these contexts have arrived for example Geoffrey Rose’s book on the Strategy of Preventive Medicine is a proxy for the concept of ‘shifting the curve’, the balance between high risk strategies and whole population strategies.
Because we are a distributed organisation, close to the populations we serve it is also difficult for people to know one another. We are also willing to show the texts that have influenced each member of the distributed leadership during the course of their professional life.
Sir Muir Gray, Consultant in Public Health
