Government 'expects' DPHs to report to council chief execs

There has been growing concern among the public health community in recent weeks over the transfer of directors of public health to local authorities.

The Association of Directors of Public Health and the Faculty of Public Health both say they have evidence that some local authorities are planning to make directors of public health report to the director of adult social services and not the chief executive.

They have warned this will prevent directors of public health playing the strategic role envisaged in the public health white paper and will also encourage some to leave the specialty altogether.

Giving evidence to a health select committee inquiry into the government’s health reform amendments today, Mr Lansley said it was “a matter for local authorities how they precisely structure themselves”.

But he said: “Our expectation is that directors of public health by the nature of their responsibilities, seniority and indeed if you look at health and wellbeing boards – the scale and shape of the responsibilities they’ll have in future –that they should be officers of the local authority who are likely to be chief officers reporting directly to a chief executive.”

Mr Lansley added: “We are expecting through the establishment of health and wellbeing boards and the transfer of budgets for there to be clearly an enhanced status for director of public health in the future.”

Committee chair Stephen Dorrell questioned whether recruiting directors of public health into positions reporting to directors of social services was “compatible with the government’s policy” ambitions for public health.

He said: “It clearly wouldn’t be consistent with enhanced status for a director of public health who used to be a chief officer in the NHS responsible for 80 per cent of the health and social care system to be a junior officer reporting to the director of social services who is responsible for 20 per cent of the local health and social care economy.”

In response, Mr Lansley repeated that he thought it was a “matter for local authorities themselves to decide how they structure their reporting responsibilities” but said “it is my expectation that a director of public health would rank, in a sense, alongside directors of adult social services or children’s social services as a budget holder with executive responsibility”.

Mr Dorrell added: “I think it’s likely to be a subject to which the committee would like to return.”

Speaking yesterday at the annual conference of the Faculty of Public Health in Birmingham, Sandwell PCT director of public health John Middleton said he was generally positive about the move to local authorities but had concerns about status.

Dr Middleton, who is also vice president of the faculty, said: “As a director of public health, I am a executive officer of a statutory organisation and it does feel to me that that is something we need to protect, preserve and maintain into local authorities.

“Directors of public health need to be able to influence all of the aspects of council policy and not be seen just as a sub section of social care or some other part of the council.”

Speaking at the same event, Leicestershire of County councillors David Sprason, lead member for adult social care and Ernie White, lead member for health, said the director of public health should report to the chief executive.

Mr White told delegates: “If the director of public health sits alongside the other directorate levels, it means you take that agenda as seriously as the other ones.”

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