Agenda item

8.1

RESOLVED: On the motion of Councillor Peter Rippon and seconded by Councillor Julie Dore, that the provisions of Council Procedure Rule 5.5 be suspended and the termination of the meeting be extended by a period of up to 30 minutes, to 6.00 p.m. maximum.

8.2

The Council received a presentation by Greg Fell, Director of Public Health, concerning the Director of Public Health Annual Report for Sheffield 2018. The report focused on the relationship between health, work and the economy. It considered how good work and an inclusive economy could make a significant contribution to improvement in Sheffield’s health and wellbeing and how, in turn, good health represented a key requirement for future prosperity.

8.3

Greg Fell summarised the key messages within the Annual report, as follows:

8.4

The economy is everything that happens in Sheffield; a healthy population and productive economy are linked; good jobs are good for health; many have been left behind by the way the economy works and inequality in health outcomes were related to economic inequalities; to change how we measure growth; and “sweat our assets” - an approach to an inclusive economy. 

8.5

The presentation examined a health summary for Sheffield, including how it compared with other places in England by various indicators such as life expectancy and cause of death, behaviour risk factors, child health, inequalities and the wider determinants of health.

8.6

Mr Fell outlined three key recommendations, made in the Annual Report, as follows:-

·         Sheffield City Council, Sheffield City Partnership and Sheffield City Regionshould align and embed action into their economic strategies to enable and encourage all local employers to recognise their role in providing good work and ensuring that the most disadvantaged in our society are not left behind in their ambitions.

·         Sheffield City Partnership, as part of developing a strategy for an inclusive economy, should consider how best to use the resources currently available to the City, to incentivise implementation of the strategy; and

·         Sheffield City Partnership should facilitate the public, private and voluntary anchor institutions of Sheffield to develop a collective strategy to secure and progress their contribution to an inclusive economy, underpinned by supportive strategies for each sector.

8.7

Members of the Council asked questions and commented upon issues raised by the Director of Public Health’s Annual Report and presentation and these, together with the responses to them, are summarised below:

8.8

A comment was made concerning employment and the effects of inequality, insecure employment and bad jobs; and the importance of defining what a good job looked like and people having the opportunity to representation in the workplace by a union.

8.9

A comment was made concerning mental health awareness and solutions and a question asked as to what the health services and the Council could do to support people with mental health conditions to stay in work. Health support may not fit around peoples working lives, sometimes causing them to leave employment which in turn contributed to a decline in their health and loss of good employees. What could be done to support people and towards early intervention that might allow an individual to stay in work so that their skills stayed within the economy.

8.10

A comment was made with regard to the decline in improvement of infant mortality rates. Austerity had also disproportionately affected women and the health of people who were poorer and poverty was associated with problems such as obesity and poor employment and a question was asked in relation to the impact of austerity on infants.

8.11

Greg Fell stated that austerity was not a good thing for communities. In relation to infants, it was known that the Council was broadly doing the right thing through the ‘best start’ strategy. Effort also needed to be focussed upon smoking cessation, obesity and pregnancy. Whilst midwives did commendable work in tackling smoking in pregnancy, tackling some problems was not something which they could be expected to do alone. There was probably a link between some conditions such as obesity and the effects of austerity but it was not possible to say austerity was directly responsible for infant deaths.

8.12

In relation to mental health, the NHS long term plan was published on 8 January and there was also supposed to be significant investment in mental health treatment. The issue of toxic working environments should also be examined as it was a cause of mental ill health. Mental health first aid approaches were in place in many organisations, but it was also necessary to look at causes of poor mental health. There was also an onus on employers to invest in treatment so as to keep people in work and improve people’s productivity. In relation to working environments, there might be an element of personal responsibility for people (as consumers), for example in relation to choosing to shop in real shops, rather than using online retail.

8.13

A question was asked about changing the measure of growth to be more compatible with the Report’s recommendations as set about above.

8.14

Greg Fell responded that there were a range of alternative measures of economic productivity. There were also other measures, such as the ‘happy city index’, which was a range of broader measures of wellbeing and included social measures. The City Partnership Board had looked to using a wider range of measures.

8.15

A question was asked concerning two of the Annual Report recommendations which were thought to be outside of the Council’s jurisdiction and as to how these might be achieved.

8.16

Greg Fell responded that the Annual Report related to the City as a whole and not the Council alone and the Council was a member of the Partnership Board and actively contributed to the City Region. There might be moral, if not contractual, leverage between organisations and the report attempted to set a narrative. He suggested that the Report’s recommendations were not particularly controversial. However, the report did give a number of reasons as to why those particular actions were a good idea.

8.17

A question was asked as to whether the Council had a measurable and positive impact in relation to public health. A question was also posed as to how the results relating to the numbers of physically active adults might be improved.

8.18

A question was asked concerning good quality employment. A further question was put as to how problems might be addressed, including smoking and those associated with BMI (Body Mass Index) and in relation to infant mortality.

8.19

A question was posed about how to ensure that poor health did not affect the economic potential of people aged over 50 years.

8.20

Greg Fell stated that some of healthy life metrics were still improving and the level of infant mortality was improving but the rate of improvement was slowing. The circumstances were better in Sheffield compared to other core cities and might be viewed in the context of austerity and the economic circumstances. In Sheffield, for example, smoking prevalence was 17 percent and there was an ambition to reduce that further to 10 percent by 2022. There were areas in which the City was improving and also other issues in relation to which there was work to be done, including air quality, health checks and cardio-vascular diseases.

8.21

As regards healthy life expectancy for people aged 50 and over, some conditions may not lead to someone having to stop working altogether, although these may cause restrictions or make it harder for some individuals.  This was an area to be considered further as the working age population became older and in making sure there was the right kind of work, appropriate for what people were able to do. There was also a broader issue relating to re-skilling people for another career and given increased automation in the workplace.

8.22

A question was asked in relation to air quality and the planning process and gas generation/turbine units in particular and as to whether any such major development in an area with existing poor air quality should be submitted to the Director of Public Health as part of a process for considering planning applications.

8.23

Greg Fell said that he had met this day with the Council’s Chief Planning Officer about that subject and there was work being done to systematise that process. He stated that for major applications a public health opinion would always be sought. There was an issue in relation to a definition of a ‘major’ application and in that minor applications could have a cumulative impact, so it had been agreed to address those issues, so that there was a link between the planning process and public health and appropriate advice could be given.

8.24

A comment was made about economic growth and a question was asked concerning the impact of bullying in the workplace and its effect on mental health.

8.25

A question was asked concerning the progress of recommendations from the previous year’s Annual Report concerning adverse childhood experiences.

8.26

A question was asked concerning childhood obesity and encouraging people to buy fresh food and use fresh ingredients at an early age and for families.

8.27

Greg Fell acknowledged the importance of encouraging children to obtain skills to enable them to use fresh produce and ingredients. Affordability was an issue, although there were also myths in that regard. There was also work in relation to a food strategy and with institutions, including schools, the Council and in hospitals, to reduce sugar content in foods.

8.28

In relation to Adverse Childhood Experiences (ACE), significant work had been done to quantify how many people had adverse childhood experiences. However, at this point in time, the quality of the data was a problem.  Work was also being done to consider what an ACE informed school or mental health care looked like for children and adults and in allowing people to talk about their experiences. This would be brought together to form an ACE strategy for Sheffield.

8.29

Many people had not benefitted from the way the economy had functioned. In relation to income, whilst it had increased, there was a worsening gap between best and worst and it was the relative which mattered as well as the absolute and this gap did matter in relation to health and wellbeing outcomes.

8.30

RESOLVED: That this Council notes the information contained in the Director of Public Health’s report, expresses support for the three recommendations outlined in the report for improving the health of the local population, and thanks him for his presentation.