Loads of really good conferences going on just now. Yesterday we heard about the one on Climate Change at the Royal College of Physicians, London. Today Johnny Currie reports on the UK NGO Forum - a multi-sectoral conference which brought together leading figures from public health to discuss and debate the issues around social determinants of health. So over to Johnny- Rhona

With the recognition of wide-ranging roots of health inequalities by the Department of Health (England), and the strong commitment to tackling them, it was timely for the NGO Forum to select the ‘social determinants of health’ as its conference’s theme this year.

Yesterday brought together non-governmental public health organisations from across the country, exploring how NGOs (non-governmental organisations) can work with the Department of Health (DoH) to improve health and reduce health inequalities. Previous reports have entrusted the NGO forum to acting as a “gateway to community involvement” and to act as advocates on health and well-being. Did the conference fulfil such a lofty goal though?

The day kicked off with an opening address by Dr Adshead, he Deputy Chief medical officer for England, who spoke of the ways in which the Department of Health is seeking to ameliorate inequalities in health. Dr Adshead was clearly impassioned by the issues and spoke about 2008 being a “defining” year for the NHS since, enjoying its 60^th anniversary this year, it was time to place a greater emphasis on equity in health - especially since action taken upon the Black Report and Julian Tudor Hart’s ‘inverse care law’ are long overdue. However, on questioning by one of the delegates on the topic of healthcare for asylum seekers and imminent proposals to revoke this, her answers were less encouraging and she coyly dodged giving a statement.

Perhaps most compelling of the speakers was Professor Marmot, who among his many titles and experiences ranks as the Chair of the World Health Organisation Commission on Social Determinants of Health. This commission aspires to create a global movement to improve global health and reduce health inequity, and is reviewing the global evidence base for health inequality and wider determinants of health. In his account of worldwide inequalities and the causes and effects of these, most notable perhaps was a quote by the WHO Director GeneralMargaret Chan herself who proclaimed:

“The development of society can be judged by the quality of its population’s health, the fair distribution of health across the social spectrum, and the degree of protection provided from disadvantage due to ill-health”.

With Professor Marmot’s convincing narrative and stark statistics, few in the audience could disagree with this statement.

The remainder of the day included focussed-working groups which sought to discuss how NGOs can contribute to a range of different issues: from physical activity and obesity to child development and gender. Later, Professor Jennie Popay, Professor of Sociology and Public Health at Lancaster University spoke of current global research into social exclusion, offering an interesting alternative to current, ostensibly obsolete, definitions. The afternoon was wrapped up after a series of rapid talks by various figures in the NGO trade, telling us what issue they felt merited our attention.

As is often the case, the day involved much networking and talks on individual niches of interest; an occurrence that pervades the NGO arena. The goal it seemed for the day was to create a forum in which a diverse range of sectors can collaborate to collectively influence public health. What was lacking however was sufficient representation from the sectors that impact on social determinants of health; if employment, agriculture, trade industries, transport and planning bodies (and more) are influential to health and well-being, isn’t their representation something to be sought?

Alas however, this was a forum for NGOs, and the speakers kept emphasising that NGOs are highly responsible for, and beneficial to, the public’s health. Various speakers repeatedly mentioned that NGOs should robustly defend their position as “the voice of change; the voice of the community” and various reasons which make NGOs the entirely positive body they purport to be - I remained unconvinced. The lack of accountability by NGO service providers, and their tendency to advocate on behalf of media-savvy and opportune issues, does not alwys mean that the NGO is the supreme corpus it claims to be.

At least the lunch and refreshments were provided by the Department of Health though.!Jonathan Currie

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