MEMORANDUM BY VALERIE LITTLE ON BEHALF
OF THE BLACK COUNTRY HEALTH AND REGENERATION GROUP (PH 86)
From the Black Country the Committee will meet:
Currently Director of Health Planning at Sandwell
Health Authority where she has been responsible inter alia
for the Health Improvement Programme. In January 2001 Valerie
will take up post as Director for Health and Regenerationa
joint appointment between Walsall MBC and Walsall Health Authority.
We believe this to be a unique post. From January to July 2000
Valerie worked on a part-time secondment basis for West Midlands
NHSE examining ways of strengthening the links and joint working
between the WMNHSE and the Regional Development AgencyAdvantage
West Midlands (AWM). Valerie is the recently elected chair of
the Black Country Health and Regeneration Task Group.
John is a public health worker with Walsall
West HAZ. Having previously worked on City Challenge projects
in Wolverhampton, John has been able to employ community development
practices and philosophy to the public health agenda in this deprived
John is one of the two voluntary sector representatives
on the West HAZ Steering Group, working for the Pool Hayes Community
Association, which is run by local residents.
The Black Country is a sub-region of the West
Midlands, located to the north and west of Birmingham and comprising
the metropolitan boroughs of Dudley, Sandwell, Walsall and Wolverhampton.
It takes its name from the colour of the ground, lying across
the famous 10 yard coal seam. 1.1 million people live in these
boroughs, which consist of traditional interdependent industrial
towns and urban villages. Over one tenth of the population are
from ethnic minorities, with especially significant Indian, Afro-Caribbean
and Pakistani communities. The area is having to adapt rapidly
to changing global economic pressures. This notwithstanding, there
remains a substantial manufacturing sector in the economy of the
sub-region. The majority of the 36,000 businesses in the Black
Country are small firms employing no more than 24 people. These
firms experience skill shortages, while in the resident population
there are low rates of educational achievement, exacerbated by
poor access to training.
A century and a half of heavy and basic extractive
industry, together with cataclysmic changes in manufacturing over
the last 20 years have left a legacy of poor health, which shows
through in higher than national average heart disease, cancer,
and early childhood mortality rates. There is a high percentage
of low birthweight babies and some of the highest teenage pregnancy
rates in the country. Approximately a quarter of 10-15 year olds
are regular drug users, with 60 per cent of acquisitive crime
assessed as drug-related.
Three of the four boroughsSandwell, Walsall
and Wolverhamptonare Health Action Zones.
Led by the four Local Authorities, a wide range
of statutory agencies, together with the voluntary sector and
business community have recently (January 1999) formed a Black
Country Regeneration Consortium, recognising the added value of
collaboration at sub-regional level on the substantial regeneration
agenda which the area faces. A Black Country Regeneration and
Health Task Group has recently been established.
Walsall Council, with Government assistance
via the Single Regeneration Budget, has developed a unique system
of local neighbourhood committees in some of its most deprived
neighbourhoods. This was a radical attempt to introduce a form
of resident self governance at neighbourhood level, which was
not without political controversy. By the end of December 1998
17 local committees had been established, all based on a model
of democratically elected local committee members, each representing
approximately 100 households. The number of committees has since
been extended by a further two.
Walsall is a second-wave HAZ. The neighbourhood
committees have provided the bedrock of community involvement
in the Health Improvement Programme and HAZ funded projects. As
there is not full coverage of neighbourhood committees across
all parts of the borough, a series of "Health Watch"
Groups has been set up to fill the gaps. Each of Walsall's four
PCG areas has a HAZ Steering Group, comprising neighbourhood committee
and Health Watch group representatives, together with PCG and
voluntary sector representatives, supported by a public health
worker. Decisions on HAZ spend have been determined by the local
West HAZ Steering Group, for example, prioritised:
Young people (teenage pregnancy/sexual
Transport links to services (out
of hours GP services etc).
Drugs, alcohol and substance abuse.
On drugs, local people identified the feelings
of helplessness and isolation often felt by the parents, partners,
brothers and sisters and other family members of people with drug
abuse problems. They determined that "every community should
have someone they can talk to locally to gain informal information
on drug issues and access to drug services". The Group has:
Commissioned an audit of locally
available services and established gaps in provision.
Provided basic drug awareness sessions
for 331 local community residents.
Offered a programme of "Listening
in the Community" accredited skills training.
Launched an outreach project "Talking
Shop" for young people using arts workers.
Worked with the over 50's in the
community to produce a video of their views on the consequences
for them of drugs issues on the estates, for discussion with youngsters
in a schools-based programme.
As a further example, East HAZ Steering Group
identified the problem that many local men pay scant attention
to their health and are certainly rarely seen in the doctors surgery.
The project has taken health checks to where the men arepubs
They used the Walsall "Arts into Health"
programme to help design and implement the programme which included
a stand-up comedy routine on men's health issues delivered in
pubs, accompanied by nurse administered health checks at the same
The initiative captured considerable media coverage,
both locally and from Canada and the USA!
The NHS National Plan focuses heavily on NHS
service delivery. There is some concern on the ground that this
may lead to a loss of momentum on the wider health inequalities
Walsall's neighbourhood committees would not
have got off the ground without SRB funding. Will the new focus
on a more narrow economic agenda set out for RDAs and regeneration
funding following the CSR, mitigate against such community based
initiatives in the future?
The Walsall HAZ public health workers have acted
as catalysts for public health action on the ground. The role
is new and is being formally evaluated. It may well provide a
model for other areas.