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Government prevaricates over public protection

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.

Notes to editors

  • FPH Press Office on 020 7935 3115 or email: news@fph.org.uk
  • The Royal College of Physicians (RCP) plays a leading role in the delivery of high quality patient care by setting standards of medical practice and promoting clinical excellence. We provide physicians in the United Kingdom and overseas with education, training and support throughout their careers. As an independent body representing over 25,000 fellows and members worldwide, we advise and work with government, the public, patients and other professions to improve health and healthcare.
  • The UK Faculty of Public Health is the leading professional body for public health specialists in the UK. It aims to advance the health and wellbeing of the population through three key areas of work: health improvement, health protection and health services. In addition to maintaining professional and educational standards for specialists in public health and providing practical information and guidance for public health professionals, FPH advocates on key public health issues, influencing policy change at the highest level, and working closely with policymakers, professionals and the public to make a positive difference to people’s health and wellbeing.
  • In its response to Healthy Lives, Healthy People (available at www.fph.org.uk) FPH called on government to:
    • Establish Public Health England as a special health authority - to maintain independence and public trust, employing all public health specialists and seconding them out to local authorities and other bodies to ensure maximum efficiency and resource allocation.
    • Position the director of public health as influential and authoritative, with the professional freedom to challenge publicly gaps in local delivery, and to manage the allocated ring-fenced public health budget to ensure it is used for public health gains.
    • Embed public health expertise in all commissioning bodies, including GP commissioning consortia, to ensure the effective and efficient commissioning (and decommissioning) of health services for local communities, ensuring that the needs of hard-to-reach groups are included.
    • Develop a coherent and comprehensive framework for the appointment and regulation of all specialists in public health - to safeguard the public.
    • Ensure sufficient funds are allocated to the ring-fenced public health budget to enable it to deliver public health gains - and provide protection to prevent it being raided to fund other services.
  • Public health is the science and art of promoting and protecting health and wellbeing, preventing ill health and prolonging life through the organised efforts of society. There are three domains of public health:

    • health improvement (including people’s lifestyles as well as inequalities in health and the wider social influences of health)
    • health protection (including infectious diseases, environmental hazards and emergency preparedness)
    • health services (including service planning, efficiency, audit and evaluation). All three domains need to be addressed actively by the public health system if the public’s health and wellbeing are to be protected and improved.