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24 May 2018
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Presidential Inauguration Address

I first arrived in the UK in the late 90s – in those days, flights from South Africa still allowed smoking. You could be in a non-smokers seat just where the smokers section started. Trapped in a closed environment of smoke for 14 hours. Annoying, but normal. You wouldn’t dream of that being normal or acceptable now. Same with smoking in pubs and restaurants – once so normal, now totally not normal, harmful to people, not acceptable. So I came to the UK and there I was as a PH trainee in a PCT in Nottingham in the early 2000s, and I remember going along to a talk on the NHS Pension. By then, I had been working quite a few years in the NHS and had been paying into the scheme diligently. I sat in a room with others, and a perfectly nice man in a suit talked us through how it worked, you know the 1 over 80 times final salary times years of membership. Then he spoke about what happened if you died and how your widow or widower benefited. It then occurred to me to check. ‘Yes – he clarified – only those who were married could get the survivor’s pension.’ It was only for straight folks in state legitimised partnerships who diligently paid into the NHS pension that benefited. Not folks like me. ‘But – he explained – that was normal’, just the way it was – inequality hidden, banal… Now, thanks to a lot of people fighting for what is just and right… I just need to get married (and of course die) and the survivor’s pension is hers! I’m sure you could think of your own stories – about class, about race or gender, about disability – of when things were supposedly just normal. But they were – or are – damaging to people, to groups of people and unjust, and they create and perpetuate inequalities in our health and wellbeing. The #MeToo generation has woken us up belatedly to the fact that people have turned a blind eye to practices and behaviours that have entrenched power, have created a norm of sexual exploitation; the exposure (yet again) of the gender pay gap suggests a norm that carries on regardless. The stories from Rochdale, Rotherham, Oxford, where ideas of the norms of race, class, gender and age enabled the sexual exploitation of hundreds of girls. Indeed some stories suggest a rolling back of positive change – the callous changes to the disability living allowance that had enabled so many people to get on with their lives in society is for me a particularly iniquitous one. Can you imagine it, people with disabilities being actively part of our society, no longer the norm. Or Brexit Britain, this week the UN Special Rapporteur on racism spoke about the ‘extreme views’ on racism having gained ground in Britain. Racism becoming normal again. ‘The harsh reality is race, ethnicity, religion, gender, disability status and related categories all continue to determine the life chances and wellbeing of people in Britain in ways that are unacceptable and in many cases unlawful’ – Tendayi Achiume, UN special rapporteur on racism So how good are we at recognising injustice and structural inequality? How much do we really understand what groups of people are experiencing because of who they are or are seen to be – and how is it impacting on their health and wellbeing? Fundamentally this is about power – and power works to keep the norm, it’s hegemonic power, something that operates very effectively in the UK. Hegemony: the dominance of one group over another, often supported by legitimating norms and ideas. The term hegemony is often used as shorthand to describe the relatively dominant position of a particular set of ideas and their associated tendency to become commonsensical and intuitive, thereby inhibiting the dissemination or even the articulation of alternative ideas. How are we complicit in this, it’s just so easy to not recognise when we have power over others, to not see things as problematic, to not see the inequality. Being white, and a professional, I recognise how steeped we are in – indeed conflicted in – what is the ‘norm’. So my personal focus as President over these 3 years is to help us make things visible, to make them problematic, to name them and for us to be comfortable with talking about them – because by challenging ourselves and upskilling ourselves, I believe we become more effective agents for social justice. The other areas of focus for my time as President were set out in my manifesto: Firstly, I’d like to prioritise you, our members:
  • It’s been fantastic to see the number of people standing for positions – it really does suggest a vibrant membership who’re keen to step up individually and be part of the collective – and well done to our new Vice President and Board members, very exciting, I’m really looking forward to working with you.
  • So I’d like to ensure we mobilise all our collective skills and dynamism, through the Council, the PAGs, and in other ways
  • I’d like us to continue to deepen ways to support and energise each other including continuing mentoring support for new DsPH
  • And I’d like to understand what your experience and your issues are, locally and respectively. So I will be coming out on regional visits – and as part of these, I’d like to not only meet you in a large room meeting setting, but see whether, alongside this, I can set up a meal or coffee with some of you, or visit to one of your boroughs at the same time.
Secondly, I pledged to promote the unique leadership role of the DPH in local government – I think our understanding of what exactly this is continues to evolve – and again I’m keen to hear your experience and views about this. What I will do to support this is work at a national level to develop strong relationships with other local government networks and associations – the LGA, ADASS, ADCS, other public health bodies - PHE, the Faculty, Royal Society – and I’m really going to try hard with the NHS… What I do think we need to do though, is consolidate our approach to sector-led improvement – DPHs as Members need to step up to the challenge of sector-led improvement.. I’d like to see a step-change in this over the next 3 years and today is an important event in helping us to do so. Lastly, the recent ADPH survey of external stakeholders showed that we are a well-respected voice for public health – and they want to hear more from us. The word ‘edgy’ was used, they’d like us to be more ‘edgy’. Now I did have a little look at the definition of edgy, and found this from Urban Dictionary: Edgy: something or someone trying too hard to be cool, almost to the point where it’s cringeworthy Interesting how words have different meaning to different people… However, we need to work out for ourselves what edgy means (and indeed whether we want to use that word, or perhaps another – suggestions welcome…). The report also recommended being really focused and prioritise only a few issues for strong advocacy. The Board, with Council, will be working on what these areas should be over the next short while. Watch this space! So those are my areas of focus:
  • Challenging the norm and advocating for equality in all its forms
  • Developing a vibrant, member-led organisation
  • Promoting our unique local system leadership role
  • Ensuring we continue to be well-respected as an organisation – but with an ‘edge’
Lastly, but most importantly, I want to acknowledge and thank Nicola and the team. They are an amazing group of individuals who work really hard to deliver the goods for us – so on behalf of members, a big thank you to the team, and here’s to 3 really great years. And you never know, we may also hear some wedding bells! Jeanelle deGruchy
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