The campaigning medic shaping the health of the town

Dr Arif Rajpura (Director of Public Health for Blackpool).
Dr Arif Rajpura (Director of Public Health for Blackpool).
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Glance across at the Bloomfield Road pitch overlooked by public health director Dr Arif Rajpura’s office and two things are obvious.

Glance across at the Bloomfield Road pitch overlooked by public health director Dr Arif Rajpura’s office and two things are obvious.

One, it’s not in the best of health itself. Scuffed grass here, bare patches, more of an obstacle course than football pitch. No wonder players kick off.

Secondly, the advertisements, the sponsors, offer a pick and mix of temptations. Drinking. Betting shops. Loan companies. Junk food.

Arif’s office overlooks the lot. He adds: “It epitomises the society we live in but all those things contribute to the misery we’ve got here in 
Blackpool. ”

Distractingly, his mobile phone goes off. The ring tone is If You Like Pina Coladas. “I just love that song,” protests the lead director on alcohol for public health in the North West.

Equally distractingly, there’s an array of wine glasses, big and small, in front of him. They are there to highlight the units of alcohol within each.

“You could get half a bottle of wine in this one,” he points out.

I know. I’ve been tempted to ask him where he got it.

“And we know,” he adds with a meaningful glance, “that people horrendously under estimate their alcohol consumption. They get a false sense of security using just one glass.”

Arif’s based in the suite of offices shared with Blackpool Football Club and NHS Blackpool’s Clinical Commissioning Group - in place of the old Primary Care Trust.

He has another at the Town Hall. Public health this month passed to local authority control. He’s got a good working relationship with the council-led health and wellbeing board chaired by Coun Ivan Taylor.

Public health is where it should be, says Arif. “It makes perfect sense in terms of partnership. And we can target our responses to needs.”

Take the Know Your Number posters around town. They relate to blood pressure. Encouraging more of us to play the numbers game has identified 650 more people with high BP. “The evidence shows that if you treat 40 people for high blood pressure you can prevent one event. Equate that to 650 people identified and treated and that’s 15 heart attacks or strokes stopped. Hugely significant when you consider the human and financial cost of a stroke.”

The football club stands at the heart of one of the most deprived districts in town.

He’s out to end the postcode lottery that may knock years off life - and undermine quality of life - by dint of being born here at the seaside rather than in Surrey Heath.

“There’s a saying: bad doctors treat diseases, good doctors treat people, and the best doctors treat populations.”

Take smoking.

“ The smoking ban was a massive public health achievement. Culturally it’s less acceptable. Here we’re still way behind. Nationally we have smoking rates of 21 per cent, here it’s 29 per cent and where we’re sat, in Bloomfield, half the adult population smoke.

“When I started here, smoking in pregnancy was 40 per cent, a shocking figure. Now it’s 30 per cent, totally unacceptable but down. The Government wants it down to seven per cent. We need to ask what makes people smoke and give them a pathway to cessation faster. “

Blackpool stands so high in the social deprivation charts medics risk nosebleeds just looking at the inner city style health related issues. Heart, cancer, liver disease blackspot. High rate of sexually transmitted infections. Clinical obesity rising. Seaside slobbery clogging terraced streets.

So what equips a teetotal middle class Muslim to cope with the cultural mindset and shift needed to stem the tide of drink and junk food and disregard to self and others?

Well, for starters, the face of public health but has a heart and social conscience.

“I come from a family of doctors. My dad’s a GP in West Yorkshire, deprivation there too, since the loss of the textile industry and mills. Public health came as a shock to him because he hoped I’d take over the practice.” His brother’s an orthopaedic registrar, his sister’s a GP.

Arif’s driven by what he saw working in Accident and Emergency. He remembers the defining moment that drove him to public health. “I was in A&E, around 3am, seeing my fifth chronic bronchitic. All long term smokers, gasping for breath. All I could do was make them comfortable, help with antibiotics, steroids, inhalers.

“But I couldn’t cure them. They were left with a condition so debilitating and with such poor quality of life.

“And I thought there’s got to be a better way to deal with this.

“That led me into thinking about prevention.

“I’d worked in areas in decline so Blackpool was no surprise. My eyes were wide open when I came here in 2007.

“There is such a significant challenge. We’ve tried to change the image of public health. Go to other places and it has this image of woolly long term thinkers.

“Here we’re strategists and action men and women.”

Arif’s a youthful 41, devoted husband and father.

He doesn’t drink, never has. He eats halal meat, doesn’t take his kids to fast food burger chains. “They have home made burgers instead.”

He can’t understand why so many see a Good Time in terms of how much booze we’ve knocked back or junk food crammed into clogged or hardened arteries.

“Alcohol is right behind our lower life expectancy, along with illicit drug use and lifestyle factors, smoking, diet, obesity.”

He’s concerned at the high death rate widely reported in the national as well as local press but says it highlights the need for better hospital coding at point of access.

“If you code someone as breathless their risk of dying shouldn’t be that great.

“If you code them as breathless with lung cancer the risk of dying is higher.

“There needs to be a closer working relationship between administrative coders and consultants who writing the notes.”

He’s anti additive laden fizzy drinks, wants us to limit if not quit alcohol, cut the carbs, walk and work out more, and pack in smoking - or at least within public places.

At the Hajj, the pilgrimage of a lifetime for Muslims, he was so chuffed to see smoking cessation campaigners camped outside Mecca he sent the picture back to the Blackpool team.

“There are things we can do to make the healthier choice the easier choice,” he adds.

“In smoking there are curbs on advertising, bigger retailers hide kiosks from view, there’s no marketing by stealth.

“Culturally we need to do the same with drinking. Regionally I’ve lobbed for minimum unit prices so in the absence of primary legislation let’s look at a bylaw across Lancashire and Cumbria.

“People say I’m penalising the moderate drinker but if you make the cheap and nasty stuff more expensive, the own brand cider, vodka, wine, it will be beneficial for the most hazardous drinkers.

“It won’t have an impact on the likes of Jacob’s Creek or Guinness already above 50p a unit which the moderate drinkers tend to drink.

“For a man who doesn’t drink I know a lot about it.

“I’m trying to influence the licensing committee to restrict the proliferation of alcohol outlets and look at early morning restriction orders so we shut the town centre at 3am rather than 6am. It has impact on policing, council staff and the health service with drunks in A&E when kids and babies are being brought in.

“There’s also been an epidemic of obesity since the 70s. We’re following the American trend. So now we’re shaping a new obesity strategy.

“We’ve done a lot around physical exercise. Now I want to look at more environmental issues.

“So it’s about limiting takeaways around schools, having healthier options on the high street, having a saturation policy for greasy burger places.

“Let’s get the debate out there.”