GREATER MANCHESTER CENTRE FOR HEALTH

VOLUNTEERING

Rajan Madhok

Presentation Outline

• Background

• Relevance to public health

• Proposal

• Conclusion

Global health challenges

• Inverse care • Impoverishing care• Fragmented and fragmenting care • Misdirected care• Unsafe care

Presentation Outline

• Background

• Relevance to public health

• Proposal

• Conclusion

13

Health Inequalities• People living in the poorest neighbourhoods in England

will on average die seven years earlier than people living in the richest neighbourhoods

• People living in poorer areas not only die sooner, but spend more of their lives with disability - an average total difference of 17 years

• The lower one's social and economic status, the poorer one's health is likely to be

• Health inequalities arise from a complex interaction of many factors - housing, income, education, social isolation, disability - all of which are strongly affected by one's economic and social status

• Not just moral case for addressing health inequalities, there is also a pressing economic case. Annual cost of health inequalities is between £36 billion to £40 billion through lost taxes, welfare payments and costs to the NHS

• Health inequalities are preventable.

1423

Poverty and Social OpportunityPoverty and Social Opportunity

Yet even a hundred Bangalores and Hyderabads will not, on their own, solve India’s tenacious poverty and deep-seated inequality. The very poor in India get a small – and basically indirect – share of the cake that information technology and related developments generate. The removal of poverty, particularly of extreme poverty, calls for more participatory growth on a wide basis, which is not easy to achieve across the same barriers of illiteracy, ill health, uncompleted land reforms and other sources of severe societal inequality.

1616

All lives-no matter where they are lived-have equalvalue. We live in a time when vaccines and medicines candefeat many of the world’s deadliest diseases.But advances in health too often fail to reach those whoneed them most…. More than a 1000 children dieeveryday for lack of a 15 cent measles vaccine, and 2000African children a day fall victim to malaria, a disease thatcan be prevented with a $3 mosquito net.In addition, tragically little research is done to find newvaccines or cures for diseases common in developingcountries. There are no effective vaccines for the world’sbiggest killers- malaria, HIV/AIDS and TB. In fact, of the1500 new drugs approved by the US FDA in the past 30years, only 20 were for diseases common in developingcountries.

Bill and Melinda Gates Foundation

21

-Health care inflation at 9.8 vs 7.2 general inflation-Medicare itself will crowd out all other spending except defense-USA is economically uncompetitive: £1500 to each car because of health care costs-Financial liabilities in terms of commitments to retired employees will bankrupt every city

22

Threats to National Security-Visible: -outbreaks/bioterrorism- Hidden:-Failed basic health systems-Catastrophic illness for poor

Evidence to Commission on Human Security

‘‘The factory of the future will have only two The factory of the future will have only two employees, a man and a dog. The man will be there to employees, a man and a dog. The man will be there to feed the dog. The dog will be there to keep the man feed the dog. The dog will be there to keep the man from touching the equipment.’from touching the equipment.’

Warren BennisWarren Bennis

24

Presentation Outline

• Background

• Relevance to public health

• Proposal

• Conclusion

FAD SURFING (n): the practice of riding the crest of the latest management wave and then paddling out again just in time to ride the next one; always absorbing for managers and lucrative for consultants; frequently disastrous for organisations.

Proposal

• What

• When

• How

• Who

Proposal

• What

Coordinating Centre bringing together theNHS, HEI, LAs, diaspora organisations topromote- Effective- Efficient- Economic

health volunteering.

Proposal

• When

• Started 1 March 2013

• Phase one: until Feb 2014

Proposal

• How

- Centre based at UHSM Academy- Develop the network and secure

infrastructure- Consolidate existing work in Uganda and

India- Start the Public Health programme and

initial training programmes

Launching the

India Manchester Graduate Network

introducing ....

The India Manchester

Graduate Network

Mon. 21st February, 2011

Future NHS: Public Health

£154bn

£30bn

Wanless scenarios

The “fully engaged” scenario is based on the continuous seeking of efficiency and effectiveness improvements on the supply side, and a health literate public nurturing their own health on the demand side. Measures to indicate this include:

Health Promotion

Health Seeking Behaviour

Self Care4

6

8

10

12

14

1977

-78

1982

-83

1987

-88

1992

-93

1997

-98

2002

-03

2007

-08

2012

-13

2017

-18

2022

-23

Projected UK health care spending

(% GDP public & private, annotations at 2002 -3 prices)

£96bn 2007-8

US spent 14.6% GDP in 2002 (OECD)

% GDP

Source: Wanless, 2002 Securing Our Future Health: Taking A Long -Term View

About £220 bn over 15 years

Fully engaged

Slow

upt

ake

Where are they from?

Proposal

• Who

-UHSM Academy-MAHSC-HCRI-HIEC

But………All organisations, organically…And……. You/We

Presentation Outline

• Background

• Relevance to public health

• Proposal

• Conclusion

I began to travel throughout America. First as a studentand later as a doctor, I came into contact withpoverty, hunger, and disease; with the inability to treata child because of lack of money; with the stupefactionprovoked by continual hunger and punishment, to thepoint that a father can accept the loss of a son as anunimportant accident, as occurs often in thedowntrodden classes of our American homeland. And Ibegan to realise at that time that there were things thatwere almost as important to me as becoming famousor making a significant contribution to medicalscience: I wanted to help those people.

41

How does one actually carry out a work of social welfare?

How does one unite individual endeavor with the needs ofsociety?

For this task of organization, as for all revolutionary tasks,fundamentally it is the individual who is needed. Therevolution does not, as some claim, standardize the collectivewill and the collective initiative. On the contrary, it liberatesone's individual talent. What the revolution does is orient thattalent. And our task now is to orient the creative abilities ofall medical professionals toward the tasks of social medicine.

43

I think if we are going to reform the world, and make it a better place to live in, the way to do it is not with talk about relationships of a political nature, . ….. Programs of a political nature are important end products of social quality that can be effective only if the underlying structure of social values is right. The social values are right only if the individual values are right. The place to improve the world is first in one’s own heart and head and hands, and then work outward from there. Other people can talk about how to expand the destiny of mankind. I just want to talk about how to fix a motorcycle. I think that what I have to say has more lasting value.

Where Next: The Future

“Be the change you want to see”Mahatma Gandhi

“She didn't know it couldn't be done, so she went ahead and did it"

Mary S Almanac

Health Volunteering

All this will not be finished in the first hundred days. Nor will it be finished in the first one thousand days, nor in the life time of this administration, nor even perhaps in our lifetime on this Planet. BUT LET US BEGIN.

John F. Kennedy

To Find out more

Visit

http://www.uhsm.nhs.uk/academy/Pages/cghvolunteering.aspx

Write to

rajan.madhok@btinternet.com