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

I read Alan Maynard's article with amusement. He is regrettably misinformed and woefully out of date about the role of public health physicians. Our role is far wider than prioritisation and cost-effectiveness.

It includes developing clinically effective services, challenging clinical practice, tackling inequalities in health and health services - I could go on.

In delivering this wide agenda, public health physicians cannot work in isolation.

Leeds health authority is not alone in developing a matrix style of integrated working throughout the organisation.

Public health physicians work in multidisciplinary teams that use the skills of may different specialists (although the need for a health economist has not been felt of late).

This enables us to meet effectively the NHS's changing challenges. Never before have public health skills been in such demand.

But Professor Maynard should not be discouraged from examining critically the cost-effectiveness of people paid by the NHS.

Trust and HA chairs are paid up to£20,000 per year for three days' work a week, more than the non-medical specialists he recommends.

Many chairs do an invaluable job, working far more than their contracts demand.

But others do not. The NHS has numerous anecdotes of 'the chair from hell', who tries to be chief executive, undermines the authority of directors, and who ultimately drives experienced and committed people out of the NHS.

Indeed, in the same edition, you cite chief executives leaving because of 'personality clashes' with chairs.

So come on, Professor Maynard, scrutinise yourself and your fellow chairs.

At least your information might be up-to-date.

Dr Elizabeth Scott

Director of public health

Leeds HA