Published: 03/06/2004, Volume II4, No. 5908 Page 22

In the past couple of years public health seems to have hit the limelight. A true Cinderella, we have been given our fancy dress and an invitation to the ball in the form of Derek Wanless's reports, the Choosing Health consultation and a new focus on prevention as well as cure at the Department of Health.Yet the pumpkin and the mice are still playing around our feet.

Public health trainees represent the only way that public health will take its rightful place at the ball.Yet the scullery trainees are marginalised, under-resourced and undervalued in the agendas of change. This group is still struggling to move forward and transform into the carriage and footmen that can deliver Princess Public Health.

Training budgets are being cut by£100m nationwide - in London this translates to a£25m cut. The word from on high is that training numbers cannot be reduced and the intake must be kept rolling, but the savings must still be made. This can only lead to reduced quality.

Training schemes are already looking to remove core courses in a bid to deliver the savings. Public health training is being stripped back to its essentials; on-call may become a time-limited training experience rather than an ongoing training requirement. The pumpkin will remain a vegetable rather than a vehicle of change, and the mice will remain voiceless in a treadmill rather than individuals with the power to steer and move forward. The Faculty of Public Health and the chief medical officer need to take a strong stand to ensure that quality is not sacrificed in the name of quantity.

Dr Justin Varney Public health specialist registrar Health training scheme Greenwich primary care trust