Obituary for George Salmond, Public Health Champion

16 Apr 2019 4:24 PM | Anonymous

Public Health Association remembers one of its Champions, George Salmond

The Public Health Association awarded George Salmond its Public Health Champion award in 2001 for his involvement in public health over more than 40 years. From the outset, George Salmond’s major areas of interest were public health in primary care and in workforce issues. 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. 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 focussed largely on the inequality of access to health services. 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.

George was also associated, from its inception in the early 90s, 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.

Later in his career, Professor Salmond became a trustee of the Hamilton-based Wise Trust, with national reach overseeing a variety of mental disability related services. George chaired the board of 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 and chaired its medical reference group.

George believed 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 said 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, perhaps the most telling detail about the man is that he said he felt most happy in one of his earliest roles, in Porirua. His devotion to meetings every Thursday morning at a local café, passionately discussing the current health care issues and the access of lower socioeconomic families to good health care, was an ongoing demonstration of his loyalty and commitment to connecting our sector with its community.

We will remember George fondly among our champions of public health and send our sincerest condolences to his wife, Clare Salmond, and family.

Kua hinga te tōtara i Te Waonui a Tāne

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Letter to the Listener 28 July 2017 in response to Fever Pitch (Listener 21 July 2017)

Catherine Woulfe’s thorough investigation of rheumatic fever brings to the surface a range of important questions not only about this cruel disease, but also wider issues about health policy. The Government’s bold initiative to reduce the incidence of rheumatic fever as one of its 'Better Public Service' targets in 2012 certainly raised awareness of rheumatic fever for the general public as well as communities and families directly affected. But even when medical science and the public have a clearer understanding of the immediate causes of rheumatic fever, interventions like the $65m ‘sore throats matter’ still won’t stop the epidemic. 

Ramona Tiatia’s blunt description of the experience of affected families not only painted a picture of the impact on affected families and communities, it also highlighted the invidious choices our health funders face.  How much should we prioritise health spending between response to the urgent need of young people whose lives and potential can be devastated by the disease versus the expense of addressing the economic and social factors that underlie the reasons we have this epidemic at all?   

As several of the clinicians interviewed pointed out, it’s only when the poverty and over-crowded housing issues are addressed that we will make a real difference.

Rheumatic fever illustrates the contradictions in our health system identified in the recent American Commonwealth Fund report. Of the 11 countries the Fund monitors, the work our health professionals do is ranked among the highest. But our overall performance as a health system falls to the middle ranking because of our poor performance on access and equity. The Fund also notes that our per capita expenditure is among the cheapest. 

Failure to invest in real prevention - that is, poverty, housing, good nutrition etc. - will continue to drive conditions like rheumatic fever, whether the immediate cause is strep throat or skin sores, until we invest upstream.

Why not spend more on these conditions - the economic and social determinants of health? 

We all pay in the long run - the young people whose misery we tolerate and whose potential remains unfulfilled, the families whose sacrifices are unrewarded, and the taxpayer who picks up the tab.

Ngā mihi,
Warren Lindberg

CE Public Health Association of New Zealand


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