Are public health doctors a waste of money? Readers reply to columnist Alan Maynard

Alan Maynard's view of public health as a drains specialty is sadly dated, as is the view that public health specialists would be better value if cheaper.

The rather crudely argued economics make the erroneous assumption that public health is merely a purchasing function.

Professor Maynard appears to have forgotten that public health doctors are involved in controlling communicable disease, and their clinical skills are much in demand when E coli 157 or meningitis outbreaks occur. He also assumes that lower pay rates are appropriate and acceptable for public health specialists - those in my department would certainly take issue there.

Far more interesting would have been to look at the development of public health skills for the wide variety of situations in which they are now needed: in primary care, local authorities, regional government, universities, trusts and health authorities, to name but a few. The intelligent debate is not how to cut the cost of public health, but how to provide approved training, accredited standards, and appropriately paid posts, within a strategically planned multidisciplinary workforce.

HSJ has reported that the government is about to pose huge public health challenges in Our Healthier Nation (news and news focus, 3 June). The intention is plain: to promote and develop public health, not to cheapen its value.

Professor Sian Griffiths

Director of public health and health policy

Oxfordshire HA,

Treasurer of the Faculty of Public Health Medicine,

Co-chair

UK Public Health Association