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The PHA - an informed, collaborative and strong advocate for public health.

Joint Public Health Champion 2001  -  George Salmond

Professor George Salmond has been involved in public health for more than 40 years. Brought up in Hamilton and studying medicine at Otago, his interest in public health sprung from his residency at Auckland's Geriatric Cornwall Hospital with one of his mentors, Dr Ron Barker. He says geriatric medicine is largely about public health.

From the outset, George’s major areas of interest have been in public health, in primary care (in all its dimensions), in workforce issues, and in health workforce development.

For 20 years he worked in Wellington at the head office of the former Department of Health, initially in health services research and planning, and later as a manager and health administrator.

In 1978 Dr Salmond was a member of a three-person delegation to the Conference in Alma Ata where the World Health Organization launched its Primary Health Care Strategy. This was a seminal career experience.

In 1986 Professor Salmond was appointed Director-General of Health, a position he held for 5 years.

In 1993 he was appointed the head of the Health Services Research Centre, a joint initiative of the University of Otago and Victoria University of Wellington, which he says focussed largely on the inequality of access to health services. He says the centre grew in part out of the work he had done during the 1970s in Porirua focusing on mother and baby services and later on community health development. This work itself grew from an earlier study which showed the most affluent families have better access than poorer ones to health services in all their dimensions.

From its inception in the early 90s Professor Salmond was also associated with Healthcare Aotearoa, which was to become one of the prime movers in the advancement of the government's primary care strategy.

He was part of founding the New Zealand College of Community Medicine which later became the New Zealand component of the Faculty of Public Health in the Australasian College of Physicians. He served the College and later the Faculty in many roles including a period as Vice President of the College and Chair of the New Zealand Committee.

Today, Professor Salmond is a trustee of the Hamilton-based Wise Trust, which has national reach and oversees a variety of mental disability related services. George chairs the board of one of those services - the Blueprint Centre for Learning - a private training organisation providing a range of education and training services mainly, but not exclusively, for the mental health sector.

He also was a member of the Health Workforce Advisory Committee which recently made recommendations to the government. He chaired the medical reference group.

Professor Salmond wrote much in the early 90s about the market model being applied to health. He says now that some of the ensuing reforms were due and have resulted in efficiencies but he says that in the main, market forces have not been applied with much skill; networks were broken up and many people were disillusioned, disappointed and discouraged as a result. This could take years to put right, he says.

He says while the focus went on hospital services and waiting lists, public health, particularly community development programmes, were largely ignored.

He feels today the balance to a certain extent has been restored although market thinking still dominates too much health sector decision-making.

Another of George's passions is development of the workforce. At present this seems to be largely as a subset of industrial action which he says lacks professionalism, is not sound or responsive to community needs and is not a good way to go.

Although welcoming the development of the primary health care strategy, Dr Salmond is disappointed a stronger link has not been made between the formation of PHOs and the development of a companion workforce.

George believes the most important issue to be addressed in the health sector is the development of community health - how to get people to look after themselves. He says the country cannot go on indefinitely underwriting treatments and adding to waiting lists. Far better that people have the knowledge they need and are supported by a sound public health infrastructure to make their own decisions to improve and maintain their health before it gets to the point of needing major medical intervention.

Despite filling many different roles in the country's health sector, the contribution with which George Salmond is most happy is his work in Porirua 30 years ago. He still meets every Thursday morning at a café there with his former research colleagues and old friends. All remain passionate about good health care and access to it for lower socioeconomic families.

In his rare times away from work, George is a keen gardener, a reader of non-fiction, and a follower of cricket.

His wife of 37 years, Clare Salmond, was a Senior Lecturer in Biostatistics in the Department of Public Health at the Wellington School of Medicine. She is co-author of the five-yearly New Zealand Index of Deprivation.