Peter Baker - presentation to the All Party Parliamentary Group on Men's Health, 14 June 2011

Thank you for inviting me to speak to you today. As I’m sure you know, Men’s Health Week began yesterday, organised by the Men’s Health Forum in partnership with a score of other organisations with an interest in improving men’s health. I’m very pleased that our partners for the Week include the Department of Health, Connecting for Health and Pfizer, all of whom are represented by speakers today.

It’s beyond any doubt that further action is needed to improve men’s health. As we speak, in Brussels an event is taking place to mark the publication of an interim report on men’s health by the EU. This is the first time the EU has shown a serious interest in men’s health and it reflects the growing awareness of the scale of the problem across Europe by both officials and MEPs.

One of the most striking findings in the EU report is that over 630,000 men of working age die each year, compared to 300,000 women. This is a shocking statistic and it’s not just an issue for the poorer, eastern countries of Europe, In England and Wales, 22% of men die before the age of 65 compared to 12% of women, almost twice as many.

In Manchester, one of the worst areas for male health in England, a man still has about a 50:50 chance of reaching the age of 75. There is a six year difference in life expectancy at birth between the richest and poorest men in England and Wales and the social gradient for mortality is steeper in men than women.

If we look at one of the big killers, cancer, men are 40% more likely to die than women from any cancer. For the cancers that men and women share, like bowel and stomach cancer, men are 70% more likely to die. The cancer figures for men are so worrying that we’re making cancer the focus of our next big public health campaign. This will be called Blue September and will be launched in the UK later this year.

These poor figures do not mean that men are somehow genetically pre-programme to keel over at a young age. They are almost entirely due to risky lifestyles and poor use of health services.

And that’s where the issue we’re discussing today comes in. What’s become clearer and clearer as over the years we’ve piled up the evidence about how best to improve men’s health is that we need to find new ways of engaging men, whether that’s about changing health behaviours or improving their use of services.

We need to improve how population-wide communication campaigns appeal to men and we need to improve men’s access to traditional health services, especially in primary care. But we also need to develop new approaches that are more carefully targeted at men. That’s why we’ve put a lot of emphasis over the last few years on reaching men at work or through sport, in other words going to where men are, especially environments where they may feel more comfortable..

The Men’s Health Forum is now turning its attention to reaching men in another place where they are in vast numbers – the internet. National Statistics data for 2010 shows that 80% of men used the internet in the last three months. Of these men, 80% of used the internet every day or almost every day; 60% of men aged 65 and over used it every day or almost every day. Over 40% of these men also accessed the internet using a mobile phone or a handheld computer.

We also know there’s an upward trend in men using the internet to access health information. Over one third of men who used the internet in the last three months used it for this purpose. And that’s what we want to build on – we want to encourage more men to use digital technologies, mainly the internet but also apps, to access health information about any kind of health issue. One of our main aims is to get the proportion of men using the internet for health information up to 50% within two years.

I think that’s a very realistic objective. The internet is a medium that men are using now in vast numbers and with which most are very comfortable. Online health services are easy-to-access, easier than any other service I can think of, and mostly anonymous and confidential.

We’re not saying, of course, that the internet or apps should replace traditional services like the GP or the pharmacist. Men also need to use these services far more effectively than they do at present. Rather, we believe that the new technologies provide an opportunity for men to access information about lifestyle and health problems and make it more likely that they will go on to use other services, when they need to, more appropriately and in a more informed way.

What’s also vital is that men use services that are accurate and responsible, like our own malehealth website as well as NHS Choices, NHS Direct and many others. The new Mini Manual we’ve produced his week – it’s called Health Clicks - aims to signpost men to the reputable sites and away from the dodgy sites flogging dodgy drugs or dodgy devices.

It’s estimated that every year 330,000 men in the UK purchase counterfeit drugs, mostly from online sources. That’s an astonishing number. These men are not only at risk from whatever the supplier, who is after all a criminal, happens to put in the tablets, they are also at risk if their condition has not been properly diagnosed by a doctor. You can see how important this is by looking at one of the most common conditions for which men purchase drugs online, erectile dysfunction, otherwise known as ED. Men with ED are about one-and-a-half times more likely to experience a cardiovascular event within 10-years than men without ED. If a man self-treats for ED without being checked for the underlying conditions, such as cardiovascular disease, he could find himself in hospital – or worse – whether or not the drugs he buys turn out to be genuine.

As well as steering more men in the right direction, the Men’s Health Forum is also asking health providers to do more to use new technologies to reach men. It’s great news that NHS Choices has this week launched a new e-card for people to send health messages directly to the men in their lives. Pfizer’s Man MOT service, which the Men’s Health Forum is delighted to support, enables men to chat live to GPs and other health experts every Monday evening and every evening during Men’s Health Week. BUPA is providing a similar service for men this week via social media. These are exactly the kinds of services that we think should be more widely available.

I’d briefly like to draw your attention to some of the fantastic things that are happening this week. I’ve already mentioned what Pfizer, NHS Choices and BUPA are doing as well as our new Health Clicks booklet. If you’ve got an iPhone, take a look at our new app, Bloke Noises, and send a squelchy-sounding health message to your male friends.

Nuffield Health and Fitness and Harpers Fitness are this week offering men free passes to their leisure centres.

There will also be hundreds of local events up-and-down the country. In Blackpool, for example, the NHS PitStop project will be offering men free MOTs and an opportunity to try Tag Rugby. In the Midlands, Melton Borough Council is laying on a Men on the Move programme that includes workouts, five-as-side football and basketball sessions for men. In Charnwood in Leicestershire, men can take part in special guided walks, bowls and golf sessions during the week. North Somerset Council is offering men blood pressure checks and fitness level checks using a Nintendo Wii.

There also events in Durham, Great Yarmouth and Leeds, where Age UK is offering men a free Nintendo Wii day where they can play ten pin bowling, archery, canoeing, cycling and Wii Fit balance games.

We don’t want all this men’s health activity, fantastic though it is, to be like a meteor that flashes briefly across the sky before crashing to Earth once Men’s Health Week is over. The challenge is to sustain and develop it on a long-term basis.

What’s key to this, it seems to me, is people working in health understanding that men’s health is an inequalities issue. Inequalities are not just about income, central though that is. It’s also about how gender, race, age, disability and other equality issues cross-cut with income and each other. It’s also important to note that all public bodies have a legal duty, under the Equality Act, to tackle inequalities linked to gender and this means men’s health too.

We have a real concern that inequalities will be overlooked by health services focused on reorganisation and cutting costs. We are worried that GP consortia, whoever sits on the boards, will focus on clinical issues and finances and not on wider public health and access issues. I have to say that most GPs do not have a good track record when it comes to tackling men’s health issues.

We’d like to see men – and women too, of course – given the opportunity to make appointments with their GP online. We know that many men are deterred by the current bookings process, by having to phone up at 8am when they may be at work or on their way to work and having to negotiate with a receptionist. Some GPs now enable their patients to book appointments online so why can’t all of them?

We also believe that Consortia, as well as local Health and Wellbeing Boards, should consult men in their areas about how to deliver online health information and other digital services most effectively. The value of consulting with men was brought home to me only yesterday when someone from a regional DH office was telling me about an app under development for male truck drivers. (A great idea, by the way.) What was crystal clear from the focus groups they had run with men was that the app must not mention health in its title – the men felt that was a guaranteed turn-off – and what would work best would be liberal use of what might be described as Anglo-Saxon words and phrases.

Talking to men will also help us find out what they want to know about as well as what we, as professionals, think they ought to know about. We put the Health Clicks booklet together on the basis of what we know men look for most on the malehealth website – that’s not information about smoking, alcohol and obesity, it’s information about penis problems, the prostate, the mid-life crisis, hair loss, depression and skin problems.

If we want to improve health outcomes for the whole population, especially in the area of premature mortality, then a greater focus is needed on men simply because the overwhelming majority of premature deaths are among men. A 10% cut in premature deaths in men would save many more lives than a 10% cut among women.

And we believe that a greater focus on improving men’s health would save money too. The EU report on men’s health published today points out that men’s infrequent use of and late presentation to health services lead to higher levels of potentially preventable health problems among men and fewer treatment options. This links to the fact that the overall rate of admission to hospital is higher for men than for women for all of the main diseases and health problems.

This means that the case for action on men’s health is not just legal and moral, it’s also financial. When men die young they mostly don’t just keel over – they are unwell for some considerable time first. That’s a cost to the NHS, local authorities, the welfare benefits system and employers. Later diagnosis in men also means that they can cost both primary care and the acute sector more to treat.

The Men’s Health Forum believes that digital technologies can provide an important part of the solution for men. They can help to break down some of the barriers that currently exist between men and traditional services, enabling men to find out more about health and encouraging them to seek help sooner and from the right place.

In short, If we are serious about improving public health in this country, and men’s health in particular, I believe that new technologies can play a very significant role in tackling what is still one of the largest and most challenging health inequalities.

Once again, I would like to thank the All Party Group for discussing this issue and hopefully continuing to work with the Men’s Health Forum to ensure that the ideas we discuss can be widely implemented.

Thank you.