Despite repeated calls from the public health profession for statutory regulation of all public health specialists to ensure public protection, government is choosing dogma over public protection, warn UK Faculty of Public Health and the Royal College of Physicians.
Today the government has published its response to the Healthy Lives, Healthy People public health white paper consultation. The report sets out government’s vision for the new public health system in England. The UK Faculty of Public Health (FPH) and the Royal College of Physicians in their responses called for the statutory regulation of all public health specialists to ensure they are appropriately trained, qualified and scrutinised, in order to safeguard the public.
FPH president, Professor Lindsey Davies said:
Directors of public health (DPHs) and public health consultants make huge decisions that have a profound effect on people’s lives. They already have big responsibilities, and in the new system they will have even more. The public deserves to be reassured that people in those posts are properly qualified and are keeping up their professional standards. We have insisted on statutory registration for doctors, who treat one person at a time - surely it’s even more important for directors of public health and other public health specialists, whose decisions affect many thousands of people? I just don’t understand why the government are dragging their feet over this.
Whilst public protection through statutory regulation of the public health profession remains a major sticking point in the new vision for public health in England, there are some positive steps in the right direction, as Professor Davies acknowledges:
The public, professions, and government too, need to know that the public health information and advice they're getting is independent, authoritative, and based on sound evidence and practice. Establishing Public Health England as an executive agency is a step towards this – though we would prefer to see it as an NHS organisation, entirely separate from government.
The role of DPHs as local strategic leaders for health is also welcome:
It's vital that they are placed at senior level within the local authority, at least equivalent to directors of adult social services and with direct access to the chief executive and councillors, and that they have the professional freedom to challenge, if they are to achieve real public health gains," continued Professor Davies. "And I'm very pleased to see that they will continue to have a role in local health service commissioning. But we need to make sure that the right people, with the right training and qualifications are appointed. The process we have in place now does that, and we want to see that continue in the new system. These people will be the ones making the big decisions about how to tackle the next E.coli outbreak or the next pandemic. The public need to have confidence in them, their skills and their training.
Sir Richard Thompson, president of the Royal College of Physicians said:
We strongly believe that in order to protect the public, there should be statutory regulation of public health specialists. but this does not need to be through new legislation - existing systems could be easily extended. The expanding role of the Director of Public Health, as envisioned by the government, means that this will become an increasingly important issue, and could be developed immediately. This is not a nut that needs cracking, so we do not need the nutcracker of new legislation.
FPH will be responding in full to Health Lives, Healthy People – Update and Way Forward.