As a youthful surgeon in Glasgow Royal Infirmary, Sir Harry Burns was so troubled by the challenges facing poorer men and women in the city that he embarked on a new occupation path. “I grew to become very interested in the way society organised itself for the greater excellent,” he recalls. “I at some point considered the time had come to cease cutting bits out (of people) and start off pondering far more creatively about carrying out one thing to quit the bits that essential to be minimize out.”
Right after 15 many years at the hospital, 5 of them as a consultant, he took a master’s degree in public well being to pursue a theme that has because dominated his specialist life: trying to make folks more healthy, in each physique and in mind, by reinforcing the social and communitarian bonds of society.
So it is probably tiny shock that Burns, 63, will retire as Scotland’s chief medical officer following month to consider up a senior professorship in international public overall health at Strathclyde University.
Medical doctors, he once recalled, are obsessed with the triggers of condition rather than the triggers of what he calls “wellness”. In a lecture, he extra: “As a medical professional at the Royal, I by no means after wrote a death certificate saying the trigger of death was residing in a horrible residence or unemployment. Folks die of molecular deaths, this kind of as proteins coagulating in arteries and creating heart attacks and strokes. However we know that poor [social] conditions lead to poor well being and premature deaths.”
So began a specialist lifestyle devoted to turning round the overall health of a Scottish nation that remains among the unhealthiest in Europe – even though successive governments, considering that political devolution in 1999, have moved with speed to introduce a smoking ban in public locations, outlaw the sale of reduce-cost alcohol, which Burns is in no doubt will have a “important influence” on public health (albeit with the drinks business tough new legislation) and, much more not too long ago, devoting an additional £500m for “preventive measures”.
Burns, thoughtful and engaging, chooses his phrases carefully, but is in no way afraid to make a strong social comment – albeit couched in the diplomacy of the public servant keen to pressure that, of program, he is not celebration political. He says forcefully that he has usually been driven by science and by evidence and, implicitly, not by ideology. “Unless of course you have evidence all you have is viewpoint,” he says. Proof tells him that the most successful societies are individuals with strong social bonds, connection and cohesion. “I’ve worked with every health minister, in some capability, considering that 1999 and they’ve all desired to do the correct point … if you current them with the evidence they are convinced and want to move the agenda forward. We’ve produced some great strides,” he says. “It really is tougher to do that in a country ten times the size.”
Yet, for outsiders, the wellness of Scotland stays a puzzle. “What we’ve seen given that 1990 is improved mortality prices amid younger men and women – the 15-45 age group – and it is a relatively recent phenomenon,” Burns explains.
In his new task, he will concentrate on well being, “wellness” creation and social exclusion at house and abroad. He is clearly nonetheless troubled by the wellness of his personal nation, and particularly that of the densely populated area of better Glasgow – an spot that will be crucial to the outcome of the independence referendum on 18 September (he declines to say how he will vote).
Burns points to research by the Glasgow Centre for Population Health (GCPH), which is learning the problem in the city. It stresses the effectively-chronicled hyperlinks in between poverty and ill-overall health and the area’s long-established large ranges of deprivation, even though adding: “These explanations do not seem to be sufficient to explain the particularly … poor overall health of Scotland … mortality prices are particularly increased those of England and Wales”
Research in 2010 showed the deprivation profiles of Glasgow, Liverpool and Manchester to be nearly identical, however premature mortality in Glasgow was thirty% greater than in the English cities.
So is there one thing in the collective psyche of Glasgow setting it apart? On the 1 hand, Burns stresses there is nothing at all inherently distinct about Scotland. But turning to the GCPH’s studies, he notes that Glaswegians are significantly less likely to go to church, join clubs, take component in community activities or to volunteer.
The causes may possibly be a lot of and varied, but he notes that 20 many years ago existence expectancy in Scotland was similar to the European regular. Considering that then, other countries have leaped ahead because, Burns observes, mortality rates in younger individuals “down the social scale” in Scotland have not declined.
He puts part of the problem down to the de-industrialisation of west-central Scotland, allied to the breakup of effectively-established communities as old tenement blocks – social centres in their very own correct – had been demolished and residents scattered to large housing schemes on Glasgow’s outskirts. “There was some thing about ‘connectedness’ that was falling apart. Skilled perform was going. Someone at the time stated ‘all these males received jobs’, but what variety of jobs? If you have been a welder in a shipyard you were somebody, but if you have been functioning in a store someplace, effectively …”
He recalls talking to a priest from Los Angeles, who was devoted to doing work with the gangs of the Californian city. He had come to observe social issues in Glasgow, and informed Burns that “connectedness” was the crucial to social cohesion. Burns quotes him enthusiastically. “What we need to have is a compassion that stands in awe at the burdens the poor have to carry, rather than stands in judgment at the way they carry it.”
The Clydeside of Burns’ formative many years was a hive of sector – shipyards, engineering works, steel-producing complexes employing tens of thousands. He recalls, with admiration, the late Jimmy Reid, a single of the leaders of the Upper Clyde Shipbuilders eight-month operate-in in 1971-72 – following a Conservative government initially refused to give the business, which had a full purchase guide, a bridging loan to safe its potential.
As a medical pupil, Burns voted for Reid – who was a SNP supporter in later on lifestyle – to turn into rector of the University of Glasgow, and vividly recalls his rectorial address, which was printed in complete in the New York Occasions.
“Jimmy Reid understood what was happening – the alienation, the cry of guys who have been victims of blind economic forces past their manage, a feeling of despair and hopelessness,” he observes thoughtfully. “Folks who do not feel in control over their lives struggle because the method does things to them – it does not function with them and assist them develop ‘wellness’ for themselves … when issues come about that alienate men and women, they get rid of that sense of management and a total selection of biological, as nicely as psychological, things take place.”
And on the referendum itself? Burns is non-committal. “No matter what takes place, I would want to proceed to make Scotland a greater location for individuals to live, expand and produce,” he says. Read through into that what you will.
Lives Barrhead, near Glasgow.
Household Married (wife a GP), six children.
Schooling St Aloysius’ school, Glasgow University of Glasgow, healthcare graduate University of Glasgow, master’s in public overall health.
Job From April 2014: professor of global public health, University of Strathclyde 2005-14: chief healthcare officer, Scotland 1994-2005: director of public health, Higher Glasgow Overall health Board 1990-94: medical director, Glasgow Royal Infirmary 1984-89: consultant surgeon and senior lecturer in surgical treatment, Glasgow Royal Infirmary 1974-84: surgeon at Glasgow Royal Infirmary.
Interests Cycling, operating, hill walking.