Thursday 18 December 2003

PROFESSOR IAIN BROOM, MS LOUISE MANN, MS AMANDA AVERY, MS SALLY HAYES AND MS EMMA CROFT

  Q1100 Dr Naysmith: Have you any hints on how we can get it to a higher level?

  Ms Croft: Making it a bigger obesity management priority for them as well in whatever targets they have. This might include working with health and offering appropriate activities.

  Q1101 Dr Naysmith: Professor Broom has probably got ideas on how this can be pushed up the agenda.

  Professor Broom: As I said, it should be part of any programme of weight management. That really is up to the individual patient and the individual practice as to how that is best dealt with. Certainly, the prescription of exercise or attendance at leisure centres should be part of a solution, if that is acceptable to the patient and acceptable to the GP or the practice nurse or whoever is dealing with this process. That is very patchy at the moment, around the UK. Some practices will prescribe exercise and that is fine. I totally agree with that, but it is very, very patchy.

  Ms Avery: Sadly, some of the difficulties around partnership working at PCT level with other organisations I feel have been created by many of the structural changes at PCT level over recent years. People who championed the obesity cause perhaps moved on. Within our PCT there are good examples of partnership working, but continuity is required over a number of years to establish good outcomes.

  Q1102 Dr Taylor: Continuing on the subject of working together, are your PCT public health specialists pushing obesity? Do you get any help from your local public health specialists?

  Ms Hayes: Yes.

  Ms Croft: Yes.

  Q1103 Dr Taylor: Are they aware of the problem in pushing this? In other inquiries we have had lots of feelings that public health is not perhaps grasping the nettle.

  Ms Hayes: I go back to the issue that obesity is one priority amongst a whole raft of priorities. Where does it come in that raft of priorities? You are right; we need to get it on to the agenda at public health level. Currently it is about individual public health doctors recognising obesity as a priority and setting local priority. The idea of setting standards and milestones through the NSF route is very interesting, and also the introduction of quality indicators within the new GMS contract. To me, that is the key driver at both PCT and practice level in each individual GP practice, so that they have targets around their obese population. It will make GPs sit up and listen to this as an issue.

  Chairman: There are issues we may want to come back to arising from this session, and you might like to expand on one or two points. I can see that one or two of you still want to come in and say something. Thank you very much for your help in giving evidence. We are most grateful to you.