More than a quarter of London primary care trusts have no public health director and 13 per cent of PCTs in England have also failed to fill the key post.
The figures, collated by the Association of Public Health Directors and shared with HSJ exclusively, have led to concerns PCTs are “asset stripping” public health functions ahead of the handover to local authorities.
There are concerns that if future local authority public health budgets are based on PCT latest spending patterns, they could be left with far fewer resources for public health than PCTs have had over recent years.
The APHD’s figures show that as of September eight of London’s 31 PCTs had unfilled vacancies for dedicated public health directors, with a further 12 vacancies outside the capital.
Association president Frank Atherton said the vacancies had the effect of “reducing public health spend in advance of the transfer to local government”.
Dr Atherton said such public health “asset stripping” was being made under the label of “reducing management costs”.
He added there would be “major problems” if the government used current spending as the basis of future budgets. “Our hope is that the transfer of resource to local authorities will be based either on historic spend or a national formula that is a percentage spend of PCTs.”
Local Government Association policy lead on health Andrew Cozens told HSJ that the representative body of councils in England shared the concerns of public health directors.
He said: “In opposition Andrew Lansley said that 4 per cent of NHS spending was on public health but we do not know if this is what will be transferred to councils.
“If it is 4 per cent is that before or after the cuts? Does that figure have to pay for the massive costs of the transition?”
A Department of Health spokesman said: “Directors of public health are essential to deliver our public health service and we expect PCTs to seek to fill vacancies as soon as possible.”
A spokeswoman for one of the PCTs with no permanent director - NHS Havering - said it would not appoint a permanent director until it knew the outcome of the imminent public health white paper.