Examination of Witnesses (Questions 140
- 159)
WEDNESDAY 7 FEBRUARY 2001
DR HUGO
CROMBIE, MS
LUCY HAMER,
MR LEN
ALMOND, MR
TERRY ROBINSON
AND MR
PETER ASHCROFT
140. I am sorry to interrupt, but you are from
the Countryside Agency. I can walk for 30 minutes in the country
without crossing roads but the problem is in London I cannot walk
for 10 minutes from my flat to the office without crossing roads.
That is the hurdle we have in the towns and cities which is actually
the focus of the report.
(Mr Ashcroft) I was talking generally about increasing
walking, but coming on to the second point in your question, the
big challenge for all of us is to reduce the obstacles which are
deterring people from walking, and those obstacles are most evident
in towns and cities, and that is probably where most of the effort
is required.
(Mr Robinson) We think it is feasible, in fact we
have done six pilots to show it is feasible, to build dedicated
networks for non-motorised use - cycling, walking, running—in
and around towns and cities. The pilots have shown the communities
in which it is done welcome it and they specifically recognise
that it also brings real environmental benefits which eventually,
in the best schemes, translate into improved property values,
et cetera.
(Dr Crombie) I do not think it is the responsibility
of any one particular professional group, it crosses so many professions
and so many areas. I think it is important we all join together
to achieve this joint outcome. There is obviously a responsibility
and a role for health professionals, there is a role for transport
planners and architects, there is a role for schools and so forth,
but it is something which needs activity in a large number of
sectors.
Mr Stevenson
141. How do we get those professionals to work
together in a co-ordinated fashion to promote walking? As someone
who spent a considerable number of my formative years in local
government, I was amazed at some of the barriers between the professions
and I have no doubt they are still there.
(Ms Hamer) I have been doing some work around the
country and, you are right, in lots of places there are still
a lot of barriers between people working in health and in transport.
However, we have a really great opportunity at the moment in that
now local transport plans are being written in which walking is
supposed to be a central component, and health improvement plans
are being written in every health area in which walking is seen
as part of the work to promote physical activity and reductions
in coronary heart disease. So there is a framework now I think
in local planning which could be used constructively. There is
still a problem in that a lot of people working in transport do
not necessarily fully know about the health benefits of walking
and how they might act to do something about it, and a lot of
people in health have not necessarily had links with people in
transport to make those connections. What we have found across
the country is where people are starting to pool their funding
and starting to use the new flexibilities of the Health Act and
the Local Government Act which have just come through, some very
interesting projects are being set up, particularly in things
like Health Action Zones where people are working together on
health and transport initiatives.
142. I was coming to that but can you be a bit
more definitive in your examples of what is actually happening
on the ground? Can you give us some examples?
(Ms Hamer) For example, in areas where regeneration
projects are being set up in deprived parts of cities, there is
quite a lot of work—
143. I understand that—sorry to interrupt—but
can you point your finger and say, "In Huddersfield, that
is happening; in Bradford, that is happening"? It would be
interesting if there were some concrete examples.
(Ms Hamer) There is a lot of work going on in York,
for instance, which is linking health and transport professionals.
They are doing a lot of work on walking and walking routes and
access.
144. Is that about it?
(Ms Hamer) No. You might want to look at the book—
145. If you have examples, perhaps you can let
us have them.
(Ms Hamer) Yes.
146. Some structures are at least there but
what incentives are there for authorities to actually be seized
of these opportunities?
(Mr Robinson) The sort of environmental improvement
and enhancement which frees up people to exercise—freedom
of movement, walking and cycling—is also the sort of environmental
improvement we see evidence of in the 12 community forests around
the major cities. This is the sort of environmental improvement
which also brings all sorts of other benefits like the benefits
of regeneration, improvement in economic activity, improvements
in the health and value of properties, community benefits and
industry wanting to move there. It is the same environmental treatment
that delivers those benefits which also frees up people to want
to explore on foot that kind of environment.
147. I note in the Government's Coronary Heart
Disease Strategy, the organisations involved—the primary
care groups, health authorities and so on—are required to
develop their strategies for increasing physical activity by April
of this year. Have you any idea where we are with that in the
country and how many have been produced?
(Mr Almond) I do not think we will be able to achieve
the target by April this year of having every single PCG producing
those figures. I think a lot are moving towards that and certainly
at least half will have those available. One of the major problems
in the past is that there has been no record on GP computers of
levels of activity and inactivity, and now people are beginning
to collect the information and put it on to the computer and very
soon everybody will have that information available.
148. A simple thing like, "When you come
to see me with an appointment, how did you get here?" for
example?
(Mr Almond) Absolutely, that is right. That is certainly
a possibility.
149. I would like now to ask about a phrase
which has been floated, " a co-ordinated communication strategy",
which sounds wonderful but I am not quite sure I understand what
it means. If you understand what it means, what form should it
take, and who should initiate this strategy? Should it be national
or local?
(Mr Almond) In Leicestershire, we have introduced
in terms of walking what is called an "exercise alliance"
where all parties concerned with physical activity meet, so we
have organised a network of alliances and partnerships to co-ordinate
all activities. Transport and Planning are also on that committee,
so we have really tried very hard. One of the things we say is
that in terms of the promotion of walking, if every local authority
had an exercise alliance which created those networks, we would
be able to influence transport and planning, and get exercise
and walking in particular on to that agenda.
150. Should such strategies be laid down by
Government in one form or another, or should they be developed
through the local transport plans and such activities?
(Mr Almond) I think there are plenty of legislation
recommendations like the Local Government Activity 2000 where
that is there already.
151. You talk about economic benefits and social
benefits such as saving lives, I am interested in establishing
whether there are any economic or social models, credible models,
which can be used to assess these benefits—economic, social,
safety and environmental benefits?
(Mr Almond) There is a model in Australia, and we
are hoping the Countryside Agency and the British Heart Foundation,
working together, can utilise the same model and apply it to this
country, because there is very little information here. There
are a number of models but the Australian model is probably the
one more applicable to us. I think there is some move by the British
Heart Foundation at the moment and some work by Glyn MacPherson
on that area and he has produced a model to illustrate how that
can be used in terms of walking and exercise, but it is not out
yet.
152. It is not out yet?
(Mr Almond) No.
153. So Government will be aware of it but they
will not have examined it?
(Mr Almond) I am sure the Government is aware of it
and I am sure the British Heart Foundation will ensure this Committee
and the Government are well aware of the implications of that
report.
Mrs Dunwoody
154. How many of the health professionals who
sit on this committee drive to them?
(Mr Almond) Drive today?
Mrs Dunwoody: Drive to the committees.
Chairman: You were talking about your alliance,
how many of those people come to the meetings by car?
Mrs Dunwoody
155. How many doctors do you get out of their
cars during a day?
(Mr Almond) I do not have the evidence. I would suspect—
156. Come on, Dr Crombie, have a good guess,
is your profession good at getting out of cars or do they love
their combustion engines more than life itself?
(Mr Almond) I think a lot of people are certainly
parking cars further away so they at least have a quarter of an
hour walk to the meetings.
157. Is that your experience, Dr Crombie, of
your own profession?
(Dr Crombie) I do not know I would say they are as
good as they should be.
158. No, that seems like a tactful remark. You
mean they are useless. They drive everywhere.
(Dr Crombie) I know some walking and cycling GPs certainly.
That was my practice when I used to—
159. How many would they represent in terms
of the medical profession?
(Dr Crombie) I must say a small proportion of GPs
will walk.
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