The appointment of the most high profile executive director responsible for public health who comes from a non-public health background has been announced.
Steve Gross has been appointed Lancashire County Council’s executive director of adult services and public health, combining the two roles. A director of public health will be appointed underneath him.
Mr Gross, a social worker by background, is the council’s director of commissioning, having previously been its director of adult social care.
HSJ’s sister title Local Government Chronicle reported in April that the council had to rethink its plans to combine the roles as director of public health and adult social care after failing to find a suitable candidate.
Council leader Jennifer Mein said: “Combining the council’s adult services and public health responsibilities presents a tremendous opportunity to improve the lives of people in Lancashire and I have every confidence in Steve’s ability to ensure we make a success of it.”
The council’s interim chief executive Jo Turton said Lancashire would “now appoint a director of public health, as part of Steve’s team, who will be our chief officer with responsibility for public health”. She said this process would be undertaken jointly with Public Health England.
John Ashton, president of the Faculty of Public Health, accused Lancashire of “driving a coach and horses through the system of specialist training for public health specialists”, which provided the knowledge of statistics and evidence-based commissioning required of executive directors.
He continued: “This is a really serious blow. An untrained internal candidate has been selected for this job over some of the leading public health people nationally.”
Professor Ashton said Lancashire’s move was part of the “dumbing down” of the status of public health professionals nationally. He warned that people with a background in social care had more experience of “remedial work”, rather than having a “pre-emptive, upstream” focus, as required in public health.
Another director of public health, who did not want to be identified, today told HSJ they feared what would happen if a director without a public health background had to deal with an outbreak of meningitis or legionella – a scenario for which they had no training.
“If you have someone in that position with no training in public health, the council puts itself into a very risky position,” the director said.
The director said they would be concerned if a public health specialist was appointed at a lower level when it was the executive director who would be required to argue the case for public health to other council directorates, councillors and outside bodies.
“It’s really short-sighted – you won’t have someone with [a public health] background who is able to influence planning decisions on the council and the commissioning of leisure facilities.
“Decisions like this undermine the move of public health into local government.”
Public health responsibility sat with the NHS before moving to local government in April under the terms of the Health Act 2012.
It is understood that Telford and Wrekin Council has adopted a similar structure to Lancashire after its director of public health left the council soon after public health functions moved from the NHS. Paul Taylor, formerly an assistant director with a social care background, holds the joint role on the authority.
Mr Gross said: “I am delighted to have been offered this post and excited about the opportunities and challenges that lie ahead. I am absolutely confident that we will use the resources we have available to deliver the best possible outcomes for the citizens of Lancashire.”