Crusader at sharp end of healthcare.

Byline: By Amanda Crook

A year after Karen Straughair took over the reins of Sunderland's medical services, the enormity of her job still occasionally amazes her.

Her role as the first chief executive of Sunderland Teaching Primary Care Trust (TCPT) includes the responsibility for improving some of the poorest health in the country.

She sees her remit as including the fight to improve housing, education, low wages and the socio-economic fortune of Wearside for the benefit of local people.

"Obviously it is a huge challenge," she says. "Sometimes when I'm lying in bed and thinking about the extent of my job I can hardly believe there is so much to it. But I love it, it is a great challenge.

"Of course, I am not tackling this alone, it is crucial the TCPT works with the council and other organisations to bring about the social changes which will make a difference to the health of Sunderland people in the long term." Ms Straughair, 40, who was born in Houghton-le-Spring, believes her "insider" knowledge is a huge advantage in her role.

She says: "I have personal experience of the health problems that Sunderland has as a result of heavy industry - my grandfather is one of those miners who died from lung cancer.

"I know just how important it is that we make changes."

Sunderland has one of the worst health records in Britain. Statistics show that coronary heart disease, strokes and particularly lung cancer all contribute to give local men a life expectancy two years shorter than the country's average.

Just this week, the Government's Chief Medical Officer, Sir Liam Donaldson, highlighted high cancer death rates in Sunderland in his annual report on the state of public health.

While cancer death rates among the under-75s fell by 6.4pc across England as a whole between the mid-1990s and the late 1990s, they rose by 3.5pc in Sunderland. There is no obvious explanation, said Sir Liam, who urged further investigation.

Ms Straughair has pounds 291m this year to use in her battle to turn around these figures for the 290,000 people of Wearside.

It is now more than 20 years since Ms Straughair joined the NHS as a management trainee, initially specialising in human resources.

Prior to her appointment at Sunderland, she was acting chief executive of Gateshead Hospitals Trust. She is married to Chris Reed, who now has that job.

At Sunderland one of her first major drives has been to tackle the shortage of family doctors, which left Sunderland one of the 10 worst places in the country for GP coverage.

Two years ago there were 133 full-time GPs working in the city's 54 practices; now there are 152.

As a result, list sizes continue to fall, with an average of 1,901 patients per practice across Sunderland now, compared to nearly 2,200 in 2001.

Ms Straughair said: "This is a very welcome trend. More GPs mean better patient services and while there is still much to be done, the signs are very encouraging.

"Progress is being made on a number of fronts to attract high-calibre professionals to fill posts in the city, which will have many benefits for patients in terms of improved access and enhanced primary care services available to them."

Much of the growth in GPs can be attributed to the increasing number of GP practices converting to PMS contracts - meaning doctors are contracted to work for the TPCT rather than the more common independent arrangements.

A local career-start scheme to support new doctors for a year (easing them gradually into general practice with the hope that they will remain in Sunderland) has also been successful. There are currently 10 newly-qualified GPs on the scheme.

Ms Straughair has been keen to take advantage of the Trust's special teaching status. Sunderland was one of the first three trusts across the country to be given the status by the Secretary of State for Health.

The Trust now works with the other PCTs across Northumberland Tyne and Wear to try new ways of working - for example, giving nurses extra training to become expert practitioners.