Geography Reference
In-Depth Information
Mission area, this San Francisco example provides a useful exemplar of the way
in which health issues are being increasingly seen as relevant in planning reviews
of new developments, irrespective of whether there is a formal HIA process in the
cities.
13.6.2
New Political Engagements and Partnerships
The need for greater political engagement is another major principle of the WHO's
Healthy City movement. Hopefully this would lead to the allocation of more fi-
nance and resources to improve health promotion and care. This new emphasis on
local political involvement in health care, instead of only medical decision-making,
has often taken time to achieve in many cities, often with limited initial results. For
example, Liverpool in England moved from setting up a Healthy City Committee
in 1988, to a Healthy City Team (HCT) in 1994, which produced a new plan for
Liverpool in co-operation with the local Primary Care Trust (Otgaar et al.
2011
).
This Trust was one of the UK's 153 similar bodies under the National Health Sys-
tem that forms the first level of health care via family doctors and dentists, etc.
Unlike the initial committee, the team had the skilled personnel to develop not only
a vision statement, but a plan for achieving their goals, and consulted widely with
citizens and medical professions and various other community groups. However, its
plan was not simply about better health care and health promotion, but also related
to how these would help to achieve greater business prosperity, social justice and
environmental protection in the city. Despite its progress the HCT was wound up
in 2000, in part because it seemed to need the greater involvement of the tradi-
tional medical professions. It was replaced by a new organization, essentially a new
partnership, which is called Liverpool First, to plan and monitor health care in the
city. This is now the joint responsibility of the Liverpool municipal council and the
local medical Primary Care Trust. This organization has a wider range of stakehold-
ers, ensuring input from many local organizations, from community groups, private
businesses and various public sector services, thereby creating a more coordinated
approach involving many people. This development in Liverpool has been dupli-
cated elsewhere, which means that the planning of health care in Britain is no longer
the domain of only the medical profession in those urban areas that have adopted
this model. The local authority connection means that there is a more democratic
basis, while the involvement of many other agencies and groups provides additional
ideas and skills, to make a more comprehensive approach to improving the health
care of residents in cities.
13.6.3
Creating Public Awareness of Health Issues
New members of the Healthy City network have to create a Health Profile to show
their situation in comparison with other centres. This creates greater public aware-
