AS chief executive of Southampton Primary Care Trust (PCT) Bob Deans is responsible for meeting the city’s health needs and managing an annual £360m budget.

The Daily Echo put him under the spotlight on questions from obesity and teenage pregnancy to whether people should be treated at home rather than hospital.

Q. Obesity rates are higher than average in Southampton. With tens of thousands spent on trying to combat the weighty problem do you think it is a lost cause?

A. Absolutely not! Staying healthy initiatives are absolutely critical for us. The reality of people not staying healthy is that they are likely to end up with health conditions that need treatment. The more we can do to prevent getting to that stage the better. There is a lot of self help information available but people need to be supported too. Our focus is mainly on how we encourage people to become more active and have the right sort of diet, for example through the eating five fruit and vegetables a day message. A new specialist community weight management service for adults is also planned for later this year to help support those with a constant weight management problem and health problems such as diabetes, cardiovascular disease and high blood pressure.

Q. Why does Southampton have an obesity problem that is worse than the rest of Hampshire?

A. I think it is just a human behaviour thing really. You will find higher obesity and smoking rates and less active communities tend to centre around big and smaller cities. The challenge for us is a little bit greater than it might be for people in more rural and less urban areas.

Q. Southampton also has one of the highest teenage pregnancy rates in the country. Are you confident the figure can be brought down and are there any new initiatives to tackle the problem?

A. It is an area that our public health teams and other services are extremely heavily focused on. We will do whatever we need to do to bring the numbers down to the levels where we think they ought to be. In the last year we have organised sexual health and wellbeing drop-in support which gives young people access to free, confidential and impartial services at eight city secondary schools and at Southampton’s three colleges.

Q. What about the problem of binge drinking? Would you like to see the same social stigma attached to binge drinking as smoking?

A. Stigma is not a word I would like to use. But I think we should have the same focus on binge drinking, alcohol intake, whatever you want to call it, as smoking. There is a greater impact on health services through people drinking heavily than there is through people smoking. I absolutely want to see us do more work with our partners on reducing binge drinking. It’s absolutely shocking when you see people coming in with advanced liver disease from drinking and you see teenagers coming in. It’s just frightening. It is a huge priority for us, through the local area agreement with the city council, to reduce alcohol damage. Our health professionals have gone out to talk to people about the consequences of alcohol abuse in pubs and on the streets.

Q. After the closure of Shirley Walk-In centre last year, some people are disappointed that they cannot use the walk-in centre at the newly opened Adelaide Health Centre in Millbrook because they are not registered with the centre’s doctors. Will that remain the case?

A. Yes. It will stay like that because the purpose of the Adelaide Health Centre is to provide a seven day a week, 12 hour daily service for registered patients. We would like to extend that type of access across the city. Bitterne Health Centre is currently a more open access walk-in centre which anyone can go to. We may go down the route of applying the Adelaide Health Centre model to the walk-in centre at Bitterne Health Centre. From this month the main walk-in centre for minor injuries will be at the new minor injuries unit at the Royal South Hants. People from all over the city with minor injuries can go there and don’t need to be registered. We would prefer them to go there than Southampton General. It provides nurse led walk-in centre services too.

Q. A patient survey carried out by the Department of Health last month found one in three people across Southampton was not sure what to do when it came to contacting an out-of-hours GP. What should they do?

A. People should only contact the out-of-hours service if they have a medical problem that cannot wait until their surgery opens. The service operates Monday to Thursday and bank holidays from 6.30pm until 8am; and from 6.30pm on Fridays until 8am on Mondays. The number is 0844 811 3060.

Q. The new organisation responsible for providing healthcare in Southampton and Portsmouth, Solent Healthcare, was launched this month. It will employ more than 4,000 staff, see more than 1.5m patients a year and have an annual budget of £180m. Why has it been set up?

A. Solent Healthcare is made up of the services that were previously provided by Southampton and Portsmouth PCTs. We’ve brought them together to provide a stronger provider organisation across the whole of south Hampshire and to look at how we can make management savings. We want to build more robust community specialised services including services for diabetes, sexual health and chronic obstructive pulmonary disease.

Q. Some staff and patients have expressed concern that they could move to Portsmouth. Is that the case?

A. No. We will continue to provide services in Southampton and Portsmouth and make them as convenient as they ever were. There will be no need for patients or frontline staff to move. However there may be a move of management staff to Southampton because that is where the head office is going to be.

Q. What’s the financial outlook for Southampton PCT?

A. The finances are looking tougher than ever. We have an increase of about 5.5 per cent on our budget from the Department of Health this year compared to last. This is the money we use to buy services from different healthcare providers (such as Southampton University Hospitals NHS Trust, which runs Southampton General). This commissioning budget is in the region of £350m to £360m. As we also provide services to other organisations our overall turnover is between £430m and £440m.

Q. Does Southampton PCT have any plans for any job cuts?

A. We are always going to look at ways to make the way we work more efficient. I cannot say whether or not there will be job cuts in the future but there are no concrete plans at present.

Q. So if you want fewer people to go to hospital where should they go?

A. There is a real sense in the NHS locally that we can improve quality while cutting costs. For example by providing better care for people at home and more self care support for people with minor illnesses. People can also go to their pharmacist, phone NHS Direct and use our GP practices, minor injury unit and walk-in centres more effectively. Together that all helps to reduce a lot of attendances at hospital which are highly costly, but I also think less accessible for patients who may end up waiting three or four hours in A&E.

Q. Is treating people in the community cheaper than in hospital?

A. There are three motivations: convenience, improved technology and cost. We know with new technologies we can provide services closer to home that are less expensive. Frankly, in the interests of managing the public purse, we have to cover all those angles and we have to minimise costs. So for example, many services that previously would have gone to Southampton General can be provided in the local community, for example hearing aid tests in the high street, blood tests at your GP and X-rays at the Royal South Hants.