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Health history and policy

July 22, 2010

By Chris Nottingham

My main current interest lies with the development of a study of child protection. As well as being a topic of intrinsic importance, it offers rich and vivid opportunities for someone concerned with the interactions between health and welfare issues and the realm of politics and policy.

It is an opportunity to write a history that could usefully illuminate the development of professional education, inter-professional relationships, the changing role of voluntary groups, and the constantly shifting relationships between politicians, the public, the media and health and welfare professionals, for child protection issues have proved one of the most powerful drivers of change in all of these areas. It is significant that concerns for child protection have recently led policy makers to link it with broader public health issues and to require the active engagement of all social and health professionals.

The project began and continues on the basis of my collaboration with Chris Robinson of the Scottish Government’s Social Work Inspection Agency. Our interest is both academic and policy-oriented, and is based on a shared dissatisfaction with existing academic studies and the overly narrow focus of the official inquiries into the many high-profile cases of recent decades. The history we are currently writing aims to capture the development of child welfare issues in Scotland from the late 19th century until the present. We believe an accurate and nuanced understanding of past practice will serve to inform current debates. To this end we have just finished an article for the British Journal of Social Work, presented papers at two international conferences and delivered a keynote address to a range of professionals at an event organised by the Scottish Forum for Professional Ethics. We also intend to produce materials suitable for use in the education of a wide range of professionals. So far we have had active engagement with social workers, health visitors, health staff at the Queen Mother’s Maternity Hospital in Glasgow and the police. Historical contextualisation, we feel, can be a useful factor in helping professionals charged with this exceptionally difficult responsibility, and so far the reactions we have had suggest that they do too. We feel we can at least broaden the terms of the debate and stimulate interagency discussions. A recent development is engagement with a large Scottish and UK government-supported research project involving health and social agencies, local government and the police, on public health and community development with a particular stress on children’s environments, in the Inverclyde district.

I am also currently leading an outreach project representing a collaboration between the Centre for the Social History of Health and Healthcare and the Royal College of Physicians and Surgeons of Glasgow. The focus of events, planned for 2011, are the Medical Officers of Health for Glasgow from the origins of the office in the mid-19th century up to its abolition in the 1974 health service reorganisation. From its development as an industrial city to the present day, Glasgow has been seen as a repository of strikingly poor population health. As such it has engaged the attention of every generation of public health reformers. In the light of this it is surprising that the Medical Officers, with the partial exception of James Burn Russell, have not attracted the historical attention that would seem appropriate.

This project will have its academic component: Glasgow clearly provides a useful case study in the development of the concept of public health itself and a useful focus for applying the conceptual frameworks that have been developed in studies of other public health regimes. However, the immediate focus will be on the organisation of an exhibition in the Royal College illustrative of the way in which the Medical Officers viewed the problems of their day, agitated and acted to alleviate them, and in the course of this made their contribution to the development of the modern city. As well as the exhibition there will be a series of lectures directed at different audiences (from older school students to postgraduates in history and the medical and health professions), articles in the Scottish press and the creation of a public health walk through the city. The success of the project will clearly depend on engaging individuals who are not currently directly involved with the Centre, and one of the benefits of the project will be to extend the reach of the Centre itself. We are currently arranging the larger organising committee, which will include academics from other institutions in the city and beyond, medical and health professionals, journalists with particular interests in health issues, independent researchers and public health professionals who have been involved in more recent efforts to improve the health of Glasgow’s population.

Dr Chris Nottingham is Head of Research in the School of Law and Social Sciences at Glasgow Caledonian University.

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