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Cycling to Public Health Edinburgh, Scotland • Thu 22 March 2018

Cycling UK hosted a unique Cycling to Public Health event in Edinburgh on Thursday 22 March 2018 which brought together for the first time health care professionals and the cycling community. The keynote speakers included Professor Chris Oliver (AKA “the Cycling Surgeon”), Honorary Professor of Physical Activity for Health at the Physical Activity for Health Research Centre, University of Edinburgh and Dr Katie Walker, GP at Cairn Medical Practice in Inverness. The event's chair was GP and broadcaster Margaret McCartney, author of “The Patient Paradox” and “The State of Medicine”, regular contributor for the British Medical Journal and broadcaster for Radio 4’s “Inside Health”.

The Cycling to Public Health event aimed to bring public health practitioners together with active travel professionals and volunteers who are interested in delivering cycling activities that are linked to health outcomes. The event featured a varied set of workshops, discussions and presentations from projects across Scotland including Glasgow’s Common Wheel, Inverness’ Velocity, Perth & Kinross’ Care Inspectorate, Stirling’s Cycle Hub, Edinburgh’s ABC Project and Alloa’s Pedal 4th.

“Cycling for Public Health is an excellent example of innovative and creative thinking about how to make a real impact on people’s health and wellbeing. Cycling is a great way for people of all ages and levels of fitness to improve their health and have fun at the same time” (Aileen Campbell MSP, Minister for Public Health and Sport, Scottish Government)

KEYNOTE SPEAKERS Q & A INTERVIEWS

Dr Margaret McCartney

Dr Margaret McCartney was the event's chair. She is a GP in Glasgow and a regular contributor for the British Medical Journal, Radio 4’s Inside Health and is the author of “The Patient Paradox: Why Sexed Up Medicine is Bad for Your Health" and "The State of Medicine: Keeping the promise of the NHS".

What will you talking about at the Cycling to Public Health event?  “I will be chairing the day and in the introduction I will talk about how cycling solves lots of policy problems and makes you feel good. Not many things do that.”

How challenging is it to bring your work as a health care professional into broadcasting/media? “I broadcast about my work - it's two sides of one coin. My major interests are in evidence based medicine, risk, public health and professionalism - cycling crosses all of these areas.”

Many cyclists feel that the wider world don’t ‘get’ cycling or its benefits - what do you think could be done to better communicate the links between cycling and health? “In some ways I think that is part of the problem. Am I a cyclist? I'm not fast. I don't like to cycle on busy roads. I usually wear normal clothes and often high heels if I'm working. Cycling is an easy happy way to get around which makes me feel good, saves stress and is better for our shared environment. I'm a person who likes to cycle. It's far less often that I do it in cleats and padded shorts - and I also have a car and do drive at work. The joy of cycling is that it has many iterations, and I wonder about parallels with parkrun. Many regular park runners (free timed 5ks in parks on Saturdays) don't describe themselves as runners, when they clearly are. Is definition part of the problem? Anyone can be a cyclist, all you have to do is get on a bike, even it it's just swopping one commute a week for a saddle. It's an open secret, and an open ‘membership'.... and anyone can join. Even in heels.”

In your role as a GP, do you think patients see cycling as part of a healthy lifestyle? And do other health care professionals in the city? “I think most people know that exercise is good. My view is that if facilities are provided, they will be used. So build cycle paths so good that you know your children will be safe on them, make it viable to commute into work on a pleasant path where you feel protected. The canal path in Glasgow is brilliant and more needs to be done to make cycling the easy option. If you feel scared you won't want to do it and you won't want your family to do it.”

If you were First Minister, what would be your top three policy recommendations for improving Scotland's health? “Policy recommendations are always difficult because of the importance of ensuring that what we do it evidence based and has been assessed for harms and cost effectiveness. And the root causes of ill health are often not in the health portfolio - employment, the benefits system, housing, education, social inequality, safe places to play, alcohol, smoking, deprivation - and these have huge impacts on health. We know that active travel is associated with better health markers and should be better for the environment, so that's easy. But I'd also actively seek out systematic ways to ensure that we were doing the nuts and bolts of healthcare better - patients and doctors could work far more effectively together to highlight things that don't work, are unsafe and wastes time and money. I think we should be doing far more to share accurate information about the risks and benefits of treatments from antibiotics to cholesterol lowering tablets to treatments offered at the end of life. Medicine tends to think its treatments are far better than they are and it's known that doctors, as well as patients, overestimate benefits and underestimate harms. More honesty is likely to lead to less but better medicine. And I'd prioritise human relationships in the NHS - staff who feel cared for are better able to care for patients.”

If you had to recommend one cycle route in and around Glasgow to a visitor, what would it be? “Easy: Canal path loop from Anniesland where I live, down to Maryhill Locks, say hello to the heron, take a right onto the Kelvin path all the way to Kelvingrove, take a right down through the university to Byres Road, and then pick a route home through the back streets. Coffee and cake optional!”

Follow Margaret on Twitter at @mgtmccartney and visit her website at www.margaretmccartney.com

Dr Chris Oliver

Dr Chris Oliver is the Honorary Professor of Physical Activity for Health at the Physical Activity for Health Research Centre (PAHRC), University of Edinburgh. He is known online as the ‘Cycling Surgeon’.

What will you talking about on 22 March? “I’ll be talking about Cycling, Health and Longevity. I will tell my own story about recovering from morbid obesity and using cycling to get fit and become an endurance cyclist (see www.theguardian.com). I will keep a cycling theme and give a general background to physical activity describing its importance to reduce sedentary behaviour. I will outline some of the Scottish Government policies relating to physical activity and describe the WHO Global Action Plan for Physical Activity. I’ll also show how physical activity is included in all the UK Chief Medical Officers guidelines for physical activity and will describe how cycling is a best investment for physical activity. I will briefly describe the evidence that shows how cycling prolongs life.“

As the Cycling Surgeon, you've clearly linked health and cycling together. Was that an obvious link throughout your life or something that you discovered later on? “I've been an orthopaedic surgeon all my life, although recently retired. I cycled as a medical student as a commuter in London. When I became obese in my 30's I was unable to cycle. I released in my late 40's that I had to lose weight and to be able to do the things as I did as a young adult, time was running out. I lost 12 stone after gastric band surgery and got cycling. I was motivated by the concept of rediscovering my past life. I had a shopping list of things to do and it got seriously out of hand, for instance I entered the National Sprint Triathlon championships and started crazy white water kayaking again. I had restored my work/life balance but was happy to take significant risks. During this process on social media I branded myself as CyclingSurgeon on Twitter. It was a way to reflect my changed life and identity, so it was something I discovered later on. Now I'm retired there's a different CyclingSurgeon, I'm still a Professor of Physical Activity for Health at University of Edinburgh, still writing papers and trying to change policy, but now looking for a newer identity and purpose.”

How do you think cycling fits into the overall health plan for Scotland? Do you feel there's a 'joined-up' strategy in place? “Cycling is integral to the Scottish Government's plan for physical activity. There was a vision for 10% of journeys by cycling for 2020 which unfortunately is not going to be met. Not enough resource got invested to achieve this goal. We do have a National Cycling Action Plan for Scotland which has been recently been refreshed. It's important for every country to have a dynamic cycling action plan that supports and helps guide policy. We do have a Cross-Party Group on "Cycling, Walking and Buses" at Holyrood which has some cross-party support. I think that cycling strategy is becoming more joined up by sterling efforts by Cycling ScotlandSustrans and Cycling UK amongst many other organisations and stakeholders. The cycling strategy is improving but is decades behind Dutch and Scandinavian infrastructure.”

If you were First Minister, what would be your top three policy recommendations for improving Scotland's health?First Commandment: Thou shall deliver 10% of the transport budget (at least) forever to active travel: walking and cycling. Second Commandment: Thou shall ensure that all new road infrastructure is segregated to protect vulnerable road users. No more roads or bridges without implicit active travel choices. Third Commandment: Universal 20mph in all urban environments.“

As an experienced international cyclist yourself, what do you think are the biggest challenges for getting people on bikes in Scotland? “I think fear of injury whilst cycling is a significant inhibitory factor especially for women. Safe routes to school are important for children and perhaps to combat obesity. We must remember that cycling per million million miles travelled is relatively safe. We mustn't go down the line of licensing bicycles or compulsory helmet laws as this would inhibit many from taking up or continuing cycling.”

You've travelled extensively to places like Bhutan, USA, Nepal, Turkey and Canada. Where else would you like to visit? “I've been very lucky to have travelled extensively. I've just come back from cycling round the vineyards in Chile. The Chileans have a better cycling infrastructure than the UK. I'd like to cycle in Patagonia but can’t afford that so I'm off to Provence in July to find some more wine.”

Follow Chris on Twitter at @CyclingSurgeon and visit his website at www.cyclingsurgeon.bike

Dr Katie Walker

Dr Katie Walker is a GP at the Cairn Medical Practice in Inverness.

What will you talking about on 22 March? “How my patient - Mick - unleashed a beast. Believe me, it's all about cycling and health and not about Snowstorms from Siberia.”

Can you tell us a little about Green CHIPS? “Well it's a terrible name but I'm very fond of it - it stands for Cycling for Health Inverness Patients and Staff. It's the umbrella under which Mick and I have plotted various cycle shenanigans which I will tell you about.”

As someone who has worked across the Highlands & Islands, do you think there are unique challenges 'selling' the health benefits of cycling in a rural environment? “I suspect so. One of the biggest problems in rural areas are the roads. It might look wee on the map but when your trunk road has lorries thundering past it isn't really conducive to getting on your bike. There just isn't the same infrastructure [as the urban locations in Scotland]. A lot of rural areas are also incredibly car-dependent as public transport links dwindle. Wouldn't it be great if all coaches allowed bikes!”

In your role as a GP, do you think patients see cycling as part of a healthy lifestyle? And do other health care professionals in your region? “I think perceptions are shifting. I'm encouraged to see more and more daily commuters wearing normal clothes. Patients talk to me about cycling to get fit. But that is still not what I strive for: we need cycling to become normal, natural and ‘oh yes, it keeps my body ticking over’. We still have a lot of work to do to convince people - health professionals especially - that getting on your bike isn't as dangerous as they think. There is a real public health campaign still needed for both patients and health professionals about the scale of benefits versus the small risk of harm.”

If you were First Minister, what would be your top three policy recommendations for improving Scotland's health? “How unrealistic am I allowed to be here? This is a really hard question: i. Free and excellent public transport - what's not to like about that? - everyone in the same bus, literally and figuratively. ii. Redesign your roads to segregate cars from bikes and make cars play second fiddle to pedestrians and cyclists. Make it a hassle to drive. iii. Get 'em moving young.”

If you had to recommend just one cycling route or destination in the Highlands & Islands, what would it be? “Nothing fancy, just a short loop for Invernesians. Out along Dores Road, turn left at Scaniport, follow the road round till you hit a T junction, turn left up Scaniport zigzags aka McBain's, huff puff a bit, then turn left again at the crossroads along the Top of the World and shoot down the truly world class descent of the Essich Road. It has it all - close to home, you can do it before work, great punchy climb, superb tarmac descent with great views on the Great Glen.”

Read more about Katie’s experience as a GP in the Highlands & Islands on the North of Scotland GP training blog www.scotlandgptraining.blogspot.co.uk

Speakers at Cycling to Public Health included:

Sheena Williamson, Inspector for the Care Inspectorate, Perth & Kinross, Stirling and Clackmannanshire

Ferga Penny, Velocity, Inverness

Cameron MacFarlane, Health and Social Care Alliance Scotland (ALISS)

Graham McQueen, Forth Environment Link / Stirling Cycle Hub

Hannah Chivers, Community Club Project Manager, Cycling UK

Emma Razi, Common Wheel community group, Glasgow

Lynn Speed, Pedal 4th, Hawkhill, Clackmannanshire

Victoria Leiper, Bike for Good Wheelbeing project, Glasgow

David Glover, ABC Development Officer, Edinburgh

Cycling UK, the national cycling charity, inspires and helps people to cycle and keep cycling, whatever kind of cycling they do or would like to do. Over a century’s experience tells us that cycling is more than useful transport; it makes you feel good, gives you a sense of freedom and creates a better environment for everyone. For more information on the Cycling to Public Health event or Cycling UK's work in Scotland, please visit www.cyclinguk.org or contact Suzanne Forup, Head of Development Scotland, on suzanne.forup@cyclinguk.org.

Credits:

© Photography Andy Catlin • Video Soundtrack Cambo "Chill Funk" (www.freemusicarchive.org/music/Cambo)

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