First do no harm

The debate is about
How to improve the health of Lambeth people
There is an easy answer and that is to work with Lambeth Council and Transport for London to redesign the transport system in Lambeth.
It is often forgotten that the main reason for the move away from motorised transport in the Netherlands was the desire to protect children. A large campaign to “Stop de Kindermoord” ("Stop the Child Murder") was successful in making town-planners redesign the roads to promote other, safer modes of transport.
At present priority is de facto given to motorised vehicles over those who walk or cycle. . Children are at increased risk of being killed or injured due to the volume of traffic.
There should be a curfew on the movement of lorries and other large vehicles within Lambeth during daylight hours.
Motor vehicle pollution is estimated to be responsible for 200,000 premature deaths in the UK as well as causing problems for patients with existing cardiac and respiratory conditions. The use of main roads in Lambeth as routes for through-traffic increases the burden of traffic pollution disproportionately on the residents of Lambeth.
Traffic pollution is a particular problem for all Lambeth residents who drive a car. Studies have found higher levels of pollution in car users compared to those who walk or cycle.
In addition the speed and volume of traffic discourages the use of Lambeth’s streets for walking, playing and cycling. This leads to problems with individual’s health which is related to the lack of activity eg increased risks of obesity, ischaemic heart disease, type two diabetes and musculoskeletal disorders. The Netherlands has half the rate of obesity that the UK has despite having a similar diet.

How to improve the quality of health services

NHS facilities in Lambeth should lead the way in promoting sustainable modes of transport. This could include well sign-posted bicycle storage that is convenient and accessible. In addition pedestrian access should not be impeded by vehicle access and non-motorised modes of transport should have the right-of-way over motorised vehicles.

Primary care providers should be encouraged to promote cycling and walking among staff by using salary-sacrifice schemes and transport cost re-imbursement that promote alternatives to driving.

All NHS facilities should be encouraged to use the cargo-bike scheme that Lambeth Council is promoting.

All new housing developments in Lambeth should have secure cycle storage facilities, safe pedestrian and wheelchair access and some green areas or tree planting as part of the development.

How to reduce inequalities in health
The development of Play Streets should be encouraged within Lambeth. The promotion of safe transport leads to the adoption of cycling and walking by all members of society. If you visit the Netherlands you will see individuals of all ages and backgrounds (including recent immigrants to the NL) using bicycles and walking. At the present time in the UK cycling is more likely to be used by white males. This is not the case in the Netherlands where children are either taken to school in specially adapted bicycles or cycle themselves to school. The costs of buying and marinating a bicycle is much lower than that of a car or using public transport.

- How to spend NHS money most wisely
See above

- A sustainable way of planning and paying for health services in the next five years and into the future.
Sustainable transport is the key to promoting increased levels of exercise, reduce air pollution and therefore mprove the health for all residents including patients with pre-existing health conditions.

I agree prevention of illness and disease is what we really have to focus over the next 5 years. Our practice is diagnosing large numbers of patients with Diabetes mainly due to Obesity. We need to encourage Lambeth people to take more exercise and eat more healthy foods. We need Public health to to work with Lambeth council and make bold decisions as creating more cycle paths, having less off licences selling alcohol, free play areas, making supermarkets provide cheaper healthy food, less fried chicken shops on high streets. There is lots of Public health evidence on what works but it needs the political will to make it happen.

I like all of the above sugegstions.

It would be really helpful if someone from Public Health or Lambeth Council could comment?

To make cycling safer and more inviting the Dutch built a vast network of cycle paths that are clearly marked, have smooth surfaces, separate signs and lights for cyclists, and are wide enough to allow side-by-side cycling and overtaking. At roundabouts it is the cyclist that has prority.

In many cities the paths are completely segregated from motorised traffic. Sometimes, where space is scant and both must share, you can see signs showing an image of a cyclist with a car behind accompanied by the words 'Bike Street: Cars are guests'. The schools plays a part in this too, with cycling proficiency lessons a compulsory part of the Dutch school curriculum. All schools have places to park bikes and at some schools 90% of pupils cycle to class.

We have a Health and WellBeing strategy in Lambeth thats drafted by Lambeth Council and the CCG. Transport is clearly an important issues and some of these ideas could be included as suggestions to work with Lambeth council on.