Thursday, May 17, 2007

May began with a trip to Hong Kong, where I was giving one of the opening speeches at the Hong Kong Hospital Authority’s annual conference (plus another one later in the programme). As the conference began on a Monday I managed to arrive a little earlier and meet up with Sian Griffiths, now Professor of Public Health at the Chinese University of Hong Kong. A former President of the Faculty of Public Health, Sian has managed to escape the chaos that the English Department of Health has visited on the public health workforce. Indeed, as I write this, the comparison between the governments successive waves of NHS re (dis) organisation and the biblical plagues comes to mind. The most recent reorganisation, in particular, has led to the early retirement of almost an entire generation of outstanding health professionals. (I have since been reminded by Angus Nicholl, now at the European Centre for Communicable Disease Control, that a similar loss of Area Medical Officers a few years ago was followed by an epidemic of whooping cough as those with the expertise to respond to public concern about the vaccine had been lost from the system.) I wonder what disaster we can now expect.
Anyway, back to Hong Kong. On the Sunday Sian organised an outing for myself , Paul Corrigan (soon to depart as our Dear Leader’s health advisor), and Selena Gray (University of West of England) to Lantau – until recently an island but now joined to the mainland as part of the developments linked to the new airport, which was built on reclaimed land on the shores of Lantau. I had forgotten how easy it is to escape from the bustle of Hong Kong to some amazing beaches and stunning mountain paths. Wonderful…. Oh, and I also managed to squeeze in a trip to the Hong Kong Museum of History. One of its many excellent exhibitions takes you from the opium wars to the 1997 handover, through streets recreated to represent different stages in Hong Kong’s history. Don’t miss it!
My first visit to Hong Kong was about 25 years ago and in the intervening years it has changed beyond recognition, not always for the better as the authorities have frequently shown a scant regard for their historical heritage. This time there was one change that was extremely welcome – on the 1st January Hong Kong had gone smoke free. Admittedly there are some exceptions, such as bars, so there is still work to be done, but restaurants, karaoke bars (not that I am likely to be seen in one) and most other public places (and many open spaces) are now free from a carcinogenic haze. Much of the credit for this must go to my good friend Judith MacKay who has worked tirelessly to expose the tactics of the tobacco industry in this part of the world.

By now, if you are still reading, you may be asking what about the conference. The organisation was a triumph, with everything running remarkably smoothly, due, in large part, to the work of Paul Hui, who seemed to be everywhere at once and totally in control. We began with the usual opening speeches from dignitaries, albeit somewhat more visionary than is usual at major conferences. Then to the opening lectures. Mine addressed the question of how health systems can maximise health gain. It allowed me to bring together a range of themes I have been talking about recently under five maxims (familiar to regular readers of this blog). These are:
Prevention is better than cure – the first step is to prevent disease arising in the first place
Timely investment pays off – you need a balanced programme of investment in people, things, and knowledge
You can’t leave it to chance (or the market) – delivery of health care needs to be planned
Anticipate change – the world is changing and so must the delivery of health care, but equally, permanent revolution (cf Trotsky, Mao, and Blair) is not a good idea
Trust but verify – learn from experience elsewhere but don’t assume that ideas are instantly transferable, Evaluate their impact.
These ideas seemed to resonate with the audience, fortunately!

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