John Ashton (public health director)

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Professor John Ashton CBE, born 1947 in Liverpool was a lecturer/senior lecturer/professor of public health at Southampton/London School of Hygiene and Tropical Medicine /and the University of Liverpool Medical School.He was Regional Director of Public Health/Regional Medical Officer for the North West of England for 13 years and Director of Public Health/County Medical Officer for 6years.He was one of the initiators of the World Health Organisation's Healthy Cities Project from 1986-88 during which time it went from being a European project to a global movement [1] and a pioneer of three public health initiatives.[2] He has criticised both UK Labour Party and UK Conservative Party health reforms, and in February 2012 the Government response to his criticism of the Health and Social Care Bill 2011 which he says "will totally dismantle the NHS"[3] was raised in Parliament[4] In January 2011, he was appointed a trustee of the National Museums Liverpool,[5] and in November 2012 he was elected as president from 2013 to 2016 of the Faculty of Public Health[6] In September 2014 Ashton took voluntary leave of absence following his use of “inappropriate and offensive language” on Twitter for which both Ashton and the FPH apologised. On 26th September, the board said it had given advice to Ashton and were looking forward to his continuing his role in office.[7]

Education[edit]

Ashton was educated at Mosspits Lane County Primary School, Newstead Farm in Quarry Bank High School in Liverpool, Newcastle University Medical School and the London School of Hygiene and Tropical Medicine.[8]

Liverpool teenage pregnancy rate reduction program[edit]

In 1982 the Health Education Council (HEC) invited the University of Liverpool, Department of Community Health to submit a proposal for a pilot project to reduce teenage pregnancy and sexually transmitted diseases.[9] At the time Liverpool had one of the highest teenage pregnancy rates in the country and the Department of Health had recommended specialised informal clinics for young people.[9] The study which liaised closely with the HEC developed contacts with a wide range of community leaders to establish support for the project.[9] Although a 1986 report by the Guttmacher Institute highlighting the disparity between pregnancy rates in different countries seemed to confirm the importance of effective contraception which in turn depended on "the degree of openness ..sex education ..and ..contraceptive advice," in January 1986 the HEC turned down the study without giving a reason.[9] Ashton believes the Victoria Gillick affair and attempts to restrict sex education in schools played a part and that a "political desire ..to control peoples behaviour ..worked against a genuine public health interest".[9] Despite advice from religious leaders that it was entirely their responsibly, the DHSS and DES insisted the program contained a strict moral message.[9] Later in 1986, fear of AIDS led to a change of attitude towards sex education.[9]

Syringe exchange program[edit]

In 1986 following advice from a visiting US expert, Ashton, then a senior lecturer at Liverpool Medical School set up one of the World's first large scale syringe exchange programmes, a policy which was adopted "across the world".[10] Subsequently the first International Harm Reduction Association conference was held in Liverpool in 1989 and in 2010 delegates were told that "pioneering work carried out in cities like Liverpool into ways to reduce the spread of HIV in drug users has saved thousands of lives."[10]

Hillsborough Disaster[edit]

Ashton was present as a spectator at the football match on 15 April 1989. He tended to some of the casualties and made a statement about the events.[11]

Liverpool Public Health Observatory[edit]

In Autumn 1990 Ashton founded Liverpool public health observatory which serves and is funded by the five primary care trusts (PCTs) on Merseyside.[12] The observatory was the first organisation to assess the medical effects of public policy.[12] Ten years later, a network of public health observatories was set up.[12]

Legionnaires Outbreak 2002[edit]

In 2002 Ashton directed the response to the Legionnaires outbreak in Barrow-in-Furness[13] which resulted in 7 fatilities, compared with 15-20 expected.[14] He was later awarded the 2002 Alwyn Smith Prize and Medal "for lifelong contributions to public health by the Faculty of Public Health."[15]

Obesity, alcohol and regional variations in life expectancy[edit]

In 2004, Ashton stated that the national diet was "a disaster and a public health emergency in the making" when research by a fitness magazine claimed "obesity and health had become a big issue for the north."[16] Male lifespan in Manchester was almost five years shorter than the UK average and Ashton blamed cultural differences, saying that the North's industrial heritage including heavy drinking at weekends.[16]

Foundation trusts[edit]

In 2006 Ashton resigned as regional director of public health in the north-west over foundation trusts which he saw as a return to pre-NHS independent hospitals.[17] He feared the result would be "a two-tier health service offering better care for the well-off and basic care for the rest" albeit all under the NHS brand.[17] He also said that hospitals would be competing with each other and people would lose confidence in the NHS when they saw nurses being dismissed because of funding cuts.[17] Ashton who had "developed a no-nonsense reputation" in his 13 years in the job was regarded as "outspoken" and described himself as "fed up with government red tape."[18]

Cumbria shootings[edit]

In November 2010 Ashton was called before the Home Affairs Select Committee to give his views on the Cumbria shootings.[19] Ashton believes the event would not have occurred without the media sensation of gun crime, in particular the reporting of the Columbine High School massacre.[19] He feared the extensive coverage in Cumbria would sow the seeds for another event somewhere in the world.[19]

NHS reforms[edit]

In 2012, the Independent published an editorial claiming that Clare Gerada, the head of the Royal College of GPs would lose out on valuable contracts if NHS changes caused increased competition.[20] Ashton was one of 23 signatories in a letter to the Independent criticising the NHS reforms as "ultimately damaging the health of the people of England" and rejecting as "grossly misleading" the earlier article.[21] He received a letter from his primary care trust advising him that it was "inappropriate for individuals to raise their personal concerns about the proposed government reforms" leading to questions being asked in parliament.[22] Health minister Simon Burns claimed the letter wasn't from the department and that PCTs should not be heavy-handed.[23] The local BBC station was telephoned by "someone from Conservative party HQ", and told it should inform viewers that Ashton was a member of the Labour party and his criticisms were politically motivated, a suggestion which Ashton described as "an outrageous smear."[24]

President of the Facility of Public Health 2013-2016[edit]

Age of consent[edit]

In November 2013, Ashton said society had to accept that a third of all children were having sex at 14 or 15. He believed a debate was necessary about lowering the age of consent to 15 so that NHS advice was available.[25] Ashton said that in countries where the age of consent was lower, teenage pregnancies were also lower. David Cameron said there were no plans to change and, whilst David Tucker of the NSPCC supported a debate, he doubted if reducing the age of consent would help. Nick Clegg and shadow public health minister Luciana Berger both opposed the move but called for better sex education.[25]

Scrapping of Warm Homes, Healthy People fund[edit]

In December 2013, Ashton criticized the scrapping of the fund which followed November's publication of reports showing 31,000 excess deaths in the cold winter of 2012-2013. He described the £20 million saved as 'peanuts' and said that it made no sense to pull money from a scheme which had demonstrated its success and popularity.[26] In response, ministers said that £2.7 billion had been transferred from the NHS to local authorities to deal with the problem.[26]

Advocation of a 4 day week[edit]

In July 2014, following the government's extension of the right to work flexible hours, Ashton suggested that a four day week would reduce both stress and unemployment whilst allowing families to spend more time together. Ashton believes work related stress is a major mental health issue.[27]

Call for doctors to be allowed to help terminally ill patients die[edit]

In July 2014 Ashton became the "most senior doctor" to support assisted dying. He called for a change in the law to allow doctors specialised in end of life care to end the suffering of those suffering "major discomfort."[28]

International responsibility to deal with third world epidemics[edit]

In August 2014, Ashton criticized what he called "the moral bankruptcy of capitalism" for being unwilling to deal with the ebola epidemic which is perceived as only a threat to poor people. He also said the international community needed to address the conditions of squalor in which epidemics can thrive.[29]

Twitter incident[edit]

Commenting on the World Health Organization’s call for a ban on e-cigarettes, which claims they can increase levels of nicotine in the air, Ashton said he didn’t support a ban but wanted to avoid young people starting to smoke.[30] During an outburst on Twitter, according to The Times, Ashton called one e-cigarette advocate a “c**t”, described users as "Onanists" [31] and faced investigation for his use of offensive language. On 26 September following an investigation the Faculty of Public Health issued a statement stating that while they have registered strong disapproval of Ashton's behavior and apologise unreservedly for what he did, they 'look forward to Professor Ashton’s continuation in the role of President'.[7]

An example of a tweet sent by Ashton on 6 September 2014.

Bibliography[edit]

References[edit]

  1. ^ "Cumbria health boss John Ashton defends NHS reform letter". BBC. 23 Feb 2012. Retrieved 4 Mar 2012. 
  2. ^ Jessica Shaughnessy (22 Jun 2006). "NW public health chief quits". Liverpool Daily Post. Retrieved 5 Mar 2012. 
  3. ^ "Liza Williams: Prof John Aston's disciplinary case shows that Health Bill critics will not be silenced". Liverpool Daily Post. 23 Feb 2012. Retrieved 2012-04-04. 
  4. ^ "Health boss in call for apology". in-cumbria. 1 March 2012. Retrieved 13 March 2012. 
  5. ^ "Trustees of National Museums Liverpool". Retrieved 11 March 2012. 
  6. ^ "John Ashton elected FPH President". FPH.org.uk. 30 November 2012. Retrieved 17 November 2013. 
  7. ^ a b UK Faculty of Public Health, retrieved 12 September 2014.
  8. ^ "John Ashton:Biography". Retrieved 14 March 2012. 
  9. ^ a b c d e f g John Ashton (1989). "True story: The Liverpool project to reduce teenage pregnancy". British Journal of Family Planning. Retrieved 13 March 2012. 
  10. ^ a b Liza Williams (29 April 2010). "Harm reduction conference remembers Liverpool's role in reducing those infected with HIV". Liverpool Daily Post. Retrieved 11 March 2012. 
  11. ^ http://hillsborough.independent.gov.uk/repository/docs/HOM000000160001.pdf
  12. ^ a b c "Welcome to the Liverpool Public Health Observatory (LPHO) web site". University of Liverpool. Retrieved 13 March 2012. 
  13. ^ "Thirty-six infected with Legionnaires' disease". Telegraph. 2 Aug 2002. Retrieved 11 March 2012. 
  14. ^ Nicola Woolcock (3 Aug 2002). "Disease 'could kill 20'". Telegraph. Retrieved 11 March 2012. 
  15. ^ "John Ashton's Biography". Debretts. Retrieved 4 March 2012. 
  16. ^ a b Sinéad Keller (30 Jan 2004). "Fat test shows Manchester really is larger than life". Guardian. Retrieved 4 Mar 2012. 
  17. ^ a b c Sarah Boseley (1 Sep 2006). "NHS becoming a brand like Nike, warns departing health director". Guardian. Retrieved 4 Mar 2012. 
  18. ^ Amanda Crook (22 June 2006). "Top doc quits after NHS shake-up". Manchester Evening News. Retrieved 11 March 2012. 
  19. ^ a b c "Media blamed for West Cumbria shootings". 3 November 2010. Retrieved 13 Mar 2012. .
  20. ^ Oliver Wright (8 Feb 2012). "Why Health Bill's biggest critic has a lot to lose from reforms". Independent. Retrieved 6 Feb 2012. 
  21. ^ "letters to the Independent:Why GPs oppose NHS changes". Independent. 13 Feb 2012. Retrieved 4 Mar 2012. 
  22. ^ "Doctor who criticised NHS reforms is threatened with disciplinary action". Guardian. 21 Feb 2012. Retrieved 4 Mar 2012. 
  23. ^ "Cumbria health bill critic asked 'to explain'". BBC. 23 Feb 2012. Retrieved 4 Mar 2012. 
  24. ^ "Critic of Health Bill claims Lansley 'smear'". Independent. 26 Feb 2012. Retrieved 4 Mar 2012. 
  25. ^ a b "PM rejects call to lower age of consent to 15". BBC News. 17 November 2013. Retrieved 17 November 2013. 
  26. ^ a b Laura Donnelly (25 December 2013). "Ministers scrap £20m scheme to keep elderly warm". Daily Telegraph. Retrieved 25 December 2013. 
  27. ^ Denis Campbell (1 July 2014). "UK needs four-day week to combat stress, says top doctor". Guardian newspapers. Retrieved 1 July 2014. 
  28. ^ Keith Perry (1 July 2014). "Let doctors use drugs to help terminally ill patients die, says health expert". Daily Telegraph. Retrieved 2 July 2014. 
  29. ^ Laurence Dodds (4 August 2014). "If Ebola was in the UK we'd cure it, says leading doctor". Retrieved 4 August 2014. 
  30. ^ Nick Triggle (5 September 2014). "E-cigarette criticisms 'alarmist' say researchers". BBC news. Retrieved 14 September 2014. 
  31. ^ The Times, 9 September 2014, E-cigarette debate heats up in online war of words, retrieved 9 September 2014

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