NHS Confederation's Yorkshire-born chair Lord Victor Adebowale says country owes it to those who died in pandemic to learn from their deaths

Life growing up in Wakefield "wasn't all strawberries and cream", says Lord Victor Adebowale, whose highly-qualified Nigerian parents moved to the UK in search of a bright future for their family.

The chairman of the NHS Confederation, a 'People's Peer' in the Lords since 2001 and whose title Baron Adebowale of Thornes refers to the area of the city which he called home, is "very proud of being a Yorkshireman and "learned a lot from my past".

His father tried repeatedly and failed to get into medical school here despite his strong academic record. And his mother, who already had the same qualifications for nursing and midwifery as were demanded here back in the early 1960s, was told she must qualify again - which she did while working in a factory.

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Two years to tackle health inequalities before they are hardwired into a generat...
NHS Confederation chair Lord Victor Adebowale

"We didn't have a lot of money, we had no money at all," Lord Adebowale says, reflecting on his childhood during a video interview from his home. "My mum brought up four kids on pretty much a nurse's salary, which is no mean feat.

"But what doesn't kill you makes you stronger, as they say. And I've been blessed with both resilience and luck to be honest."

It's not hard to see how those same two qualities have been needed in the last year by the tens of thousands of health workers whose organisations come under the umbrella of the NHS Confederation, where Lord Adebowale has been chair since last April.

A membership body bringing together and speaking on behalf of organisations that plan, commission and provide NHS services, the confederation represents hospitals, community and mental health providers, ambulance trusts, primary care networks, clinical commissioning groups and integrated care systems.

And while the latest figures show the pressure on health services from the pandemic is starting to ease, it comes after 12 months when Lord Adebowale says health and social care staff have been pushed "to the very limit of their capabilities".

"The NHS has done a remarkable job, we went into this pandemic with about 100,000 vacancies," he tells The Yorkshire Post. "So it wasn't as though we went into the pandemic fully staffed, we'd already asked the government for more money for capital, because our hospitals needed rebuilding, and we needed to maintain the performance on elective care.

"And we went into this pandemic not in the best of shape, and we're coming out of it having achieved remarkable things with not a lot.

"I think the public appreciate that, and expect politicians to reflect on that. And we have to learn, we've had over 121,000 people die. We owe it to those people to learn from those deaths."

A leading figure in the housing association movement, Lord Adebowale was made a CBE in 2000 for services to the Labour government’s New Deal and to unemployed and young homeless people, and he was appointed as one of the first “People’s Peers” in 2001, becoming a crossbench member of the Lords.

For two decades was chief executive of Turning Point, the social enterprise organisation that provides health and care services in more than 300 locations across England.

Taking on the chairmanship of the confederation as the pandemic's impact was just starting to bite, he describes it as "a really exciting opportunity to help shape the future of health and social care".

"We had to pull ourselves together, operate in a different way, get virtual as they say, but also stay in touch with our members to work out what it is that we can do for them that will add value. And that's what we've done.

"That's what the team's done. And they've done an amazing job. The confed team, people have worked 24-7, they've not taken holidays. They've worked as hard as our members, they have taken holidays now because I think you have to, but they've worked very, very hard to make sure our members are represented.

"Our health and social care members have pulled this country through one of the biggest crisis since the Second World War, but to focus on the future as well, because it's the future that will create health and wealth for all of us."

He describes in numbers the challenges posed for health services even after the pressure of Covid cases has receded. There's a backlog of 4.5 million people for elective care like surgery, as well as an extra 10 million mental health cases as a direct result of the pandemic.

And the NHS Confederation warned last week that the NHS risks losing thousands of nurses, doctors and other key workers in the longer term unless they are given the time and space to recover from the pandemic.

"So both in terms of acute care and elective surgery, there's a challenge, but the mental health challenge, I think is just as challenging," Lord Abebowale says. "We have to respond to the massive backlog in mental health, both in children and in adults, that we're going to have to face. And that's going to require investment, as well as new ways of delivering interventions across the piece."

He adds: "To be honest, we're making our views heard whether they asked for them or not, because I think it's our duty to, but we wrote to the Prime Minister recently and setting out the need for a very cautious approach to getting back to what people might call normal, which hopefully will be better than normal, which I'm glad to say he's taken up the calls that we've made.

"We've set out what needs to happen in terms of getting the show on the road for the NHS, which means resolving some of the funding issues, some of the backlog issues, not expecting things to get back to normal instantly".

There are also more longstanding health problems occupying his mind, as he revealed last year when he told a conference that the country has two years to take steps to tackle its health and wealth inequalities “before it is hardwired into a generation to come”.

As an example, he points out that in Hull life expectancy is 78 for men and 80.2 for women, two years less than the national average.

This means active life expectancy is also reduced so people start experiencing multiple health issues in their 50s instead of their 70s, as they might elsewhere, resulting in more visits to hospital. And it reinforced the damaging "inverse care law", stating that people most in need of health care are least likely to get it.

"So it's not just morally unacceptable and not why the NHS was established," Lord Abebowale says. "It's also economically and operationally unsustainable.

"So we have to tackle it. It's unreasonable and irrational for us to have that kind of differential in life expectancy and active life expectancy across the country and within regions.

"Now, some of that isn't all down to health. And as Michael Marmot, renowned epidemiologist, has pointed out, a lot of these issues related to housing, jobs, transport, etc. But health has a big part to play in ensuring that it actually works to reverse the inverse care law, and not to exacerbate it.

"And I know that my members are really focused on what they could do to move the needle in that area. I talk about it with them every time we have a conversation, so they are committed.

"And I think the government is as well, the red wall and leveling up, that's what it means. If it doesn't mean levelling up health, there's no wealth without health, so it's not 'either-or' it's 'and-and'.

A possible solution, as he describes it, is the concept of 'population health', where a health system is designed around a population in a particular area and measures are put in place that benefit everyone.

Something similar to this is already in place in West Yorkshire, where the integrated care system encourages hospital trusts, primary care, community services and local government to work together " "to move the health of the population up".

"We know if we can do that everybody benefits, that's basically what it means", Lord Adebowale said. "It is happening already. It's starting to happen, it's early days. We're building the infrastructure, we're building the partnership, we're building the relationships, some of which have been happening over some time now.

"I always think we have a duty to be optimistic, those of us that are lucky enough to live in good health, to have jobs and places to live and relationships that are positive and all that good stuff, I think we owe it to be optimistic on behalf of those people who don't.

"So I am optimistic that we are in the right place at the moment, coming out of a horrendous pandemic, we have the opportunity to learn, take that learning into the future and start reversing the inverse care law, pushing forward for those people who need it the most."