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As I conclude this, my third Annual Report on the State of the Public Health in Lothian, I want to take this opportunity to reinforce the key messages that have been presented around sustainability in health care and public health and to highlight ways in which we can all respond to them.

The recent Scottish Government Report ‘Equally Well: report of the ministerial task force on health inequalities’ (Ref.) recognised that “reducing Scotland’s deep rooted inequalities in health outcomes is a long-term task. Significant impact on health outcomes may only be achieved in a generation.” This recognition puts sustainability at the very heart of what we must do. Sustainability in health and health care is not something that can be simply bought in or provided through establishing a service to meet need. Achieving sustainability has differing consequences in different domains. As we have seen, sustaining people and place, creating services that are sustainable, or how we sustain human and resource environments to ensure they remain mutually supportive, is something that we are already doing. I believe that we must do more in recognising sustainability as an underlying value that informs what we do. This means that we need to recognise on a personal, professional and organisation level what each of us has to do in order to create a sustainable health and health care system in Lothian.

For individuals – we must accept that how we live our lives has a major impact on our health. We must recognise that we have a responsibility to ourselves – and to those around us – by seeking sustainable ways to protect and promote our own health and that of those around us. For the NHS in Lothian, its professionals and its partners – we must work to create sustainable solutions to providing health and health care services. We need to take every opportunity to use the resources made available to us wisely, to focus on what will sustain high quality, effective care. For all organisations in Lothian I encourage them to recognise the important ways in which they contribute to establishing and sustaining the health and wellbeing of those we work with and for. Sustainability will be as much about being a supportive employer as about seeking to create more sustainable, healthy environments or using resources in a renewable way.

As the Director of Public Health for Lothian, I am convinced that if we accept sustainability as a core value in what we seek to achieve, and remain committed to the sorts of roles I have noted, we will achieve better a state of sustainable health for Lothian people.

(Ref.): The Scottish Government (2008). Equally Well: report of the ministerial task force on health inequalities ISBN: 978-0-7559-5760-6, Edinburgh, the Scottish Government.