Bosses are convinced the health of the region can be drastically improved in a generation. Health Editor Barry Nelson spoke to Dr Stephen Singleton, North-East director of public health.

UNLIKE most reports about the state of public health in the North-East, "Better Health, Fairer Health" does not start with the usual grim litany of why the region has the worst health in England.

The report's author, North-East director of public health Dr Stephen Singleton, does not want to look backwards.

His eyes are firmly fixed on a tantalising future -when the North-East is the best place to live in the country, and the place with the best health and wellbeing.

He said: "This is about ambition for the future, rather than being mired in the legacy of the past.

"Instead of going on about the inevitable consequences of shipbuilding, mining etc, actually there is no reason why we cannot be the healthiest region in the country in a generation."

Apart from being angered at the immense loss of life caused by so many North-Easterners pursuing unhealthy lifestyles, he is also looking at the balance sheet.

He said: "There are billions of pounds worth of taxpayers' money at stake if we can reduce ill-health.

"There has already been a 17 per cent fall in heart attack admissions to Scottish hospitals since they brought in their smoking ban. If it has the same effect in the North-East, we are probably talking about up to £3m a year in savings to the NHS."

Dr Singleton estimates that transforming the North-East's health from the worst to the best could save about £2bn in a generation that would have been spent on treatment.

He said: "This, of course, frees up more money for things like expensive cancer drugs."

The turning point for Dr Singleton, which makes him believe that the apparently impossible can be done, has been the success of Fresh, the campaign for a smoke-free North-East.

The region was the only one in England to set up a pressure group to support the proposed workplace smoking ban.

Dr Singleton is convinced that Fresh, funded by contributions from all of the region's primary care trusts and councils, helped achieve what has been a seismic shift in public attitudes to smoking in enclosed places.

He also thinks Fresh could be the model for a similar campaign organisation, initially focusing on curbing the region's apparently insatiable lust for alcohol, but possibly used to achieve other aims of the wider healthier region drive, including tackling obesity, encouraging people to take more exercise and diagnosing cancers and mental health problems earlier.

One plan would be to mount hard-hitting television and poster advertising campaigns to persuade people that being drunk is uncool as well as unhealthy.

Statistics show that in 2003, support in the region for a workplace smoking ban, including pubs and clubs, was about 35 per cent.

Today, that is nearer to 70 per cent, and the North-East has the highest rate of compliance in the country, and the most successful smoking cessation support programmes.

Dr Singleton is also encouraged by the huge progress made in reducing premature deaths from heart disease and strokes.

From an admittedly high starting point, they are dropping faster than anywhere else.

Dr Singleton said: "We have been getting better very quickly. The key is not how we carry on getting better, but how do we go on to overtake the rest of England?

"Undoubtedly, attitudes on smoking have changed in the region. The question is, how do we build on the momentum created by the smoke-free legislation and get people to change their attitudes to alcohol and other aspects of their lifestyle?"

In a region that is infamous for its heavy drinking culture (Newcastle's party city image has not helped... not to mention Viz cartoon characters such as Biffa Bacon and The Fat Slags), Dr Singleton knows that there is a mountain to climb.

But he believes that people have had enough of city and town centres turned into no-go areas by drunken yobs, not to mention the alarming rise in liver disease among older drinkers.

He said: "Everybody knows we should be doing something about binge-drinking in young people and middle-aged people who drink heavily at home.

"We are seeing the results every day in the number of injured people coming into hospital emergency departments and the rise in cases of liver cirrhosis.

"Talk to the police; they are fed up at the mindless drinking and violence they encounter.

"Talk to the A&E doctors; they feel the same. We need a concerted regional effort to change attitudes to drinking."

Dr Singleton knows that deep-seated cultural attitudes will have to change if the plan has a chance of success.

But given widespread, co-ordinated regionwide support, Dr Singleton believes it is achievable.

More than anything, the plans need to be supported by the people of the North-East.

He said: "We are trying to stimulate debate. We need to hear what people think. What is the answer? Have we got it right?"

A copy of the draft strategy can be viewed at http://www.go-ne.gov.uk/ gone/publichealth/improvinghealth strategy