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Dual action to produce healthy nation

Links being forged by the Government did not grab headlines, but were welcomed by public health specialists. Nicolas Barnard reports

A timely alliance is taking place between the education and health worlds: both have concluded that they cannot achieve what they want - well-educated pupils, a healthy population - on their own.

Last week, as David Blunkett prepared to deliver his White Paper, education junior minister Estelle Morris joined health minister Tessa Jowell to address a public health strategy conference, demonstrating the links across services being made by the new government.

It was less high-profile, but in some ways equally far-reaching - signalling a new approach to public health in which education will play a key role.

Close analysis of the White Paper - looking beyond the headline-grabbing literacy targets and council inspections - reveals an underlying theme. It pledges to work with the health and voluntary sectors to foster health initiatives in schools.

The paper says that health visitors and school nurses can play a role in "an imaginative programme to foster the learning process" while recognising that schools have a key part to play in improving public health - both by preventing problems like teenage pregnancy and substance abuse, and in promoting good mental health by raising self-esteem and achievement.

Health workers can help start a child's education earlier by reaching out to parents while schools can teach "healthy" behaviour. Everyone benefits - healthy kids learn better, and confident children with high self-esteem are more likely to adopt a healthy lifestyle.

"Good education is a lifeline for children on the wrong side of the 'health divide'," the White Paper says.

Ms Morris told last week's conference that relationships were the fourth R - "another kind of literacy if you like - emotional literacy". She stressed a whole-school approach to personal, social and health education, and of reaching beyond the school gates to use parents, social services and health workers to reinforce messages.

Education was in a key position to give young people "good information" to make healthy choices.

Labour's White Paper also confirms the emphasis educationists now place on creating a partnership with parents as the "first and enduring teachers" of children.

Health workers have been working towards a system based on primary care - around surgeries and health centres, away from hospitals - as a system better-tuned to the needs of local people.

It's a way of organising health care that places disease prevention and the promotion of sensible lifestyles at the centre. It puts health in a social context and almost means building alliances with other sectors - industry, housing, and, naturally, education.

The concept is at the heart of the World Health Organisation's Health For All targets and will be restated even more forcefully next year when those targets are updated.

Ms Jowell says it will also be reflected in the Government's updated Health of the Nation targets - based under the Tories on the WHO targets but with WHO's references to poverty and equity as key causes of ill health dropped. Those will be returned by Labour.

"We want to attack the underlying causes of ill health and break the cycle of social and economic deprivation and social exclusion," Ms Jowell said at the conference.

For those working in the public health and health promotion fields, it is sweet music. At the Health Education Authority, there is a sense of release after years of being afraid to utter obvious but - to the last government - controversial ideas like poor health is linked to poverty.

Spokesman Richard Hunt says: "Tessa Jowell is saying things we have felt for a long time but never been in a position to push through. The new Government is very clear about what it is trying to do and inequality is an area where we can help."

That means pushing initiatives like a Young People's Health Network, and the Health Promoting Schools Network. We can expect to hear more in future.

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