Six in 10 top-tier councils have a director of public health who reports directly to the chief executive, according to research by the Faculty of Public Health.
The faculty has welcomed the finding, shared with HSJ’s sister title Local Government Chronicle, as a sign that most authorities are taking the “right approach” to their new responsibility for public health, by giving the directors a seat at the top table.
However, its president John Ashton said he believed the 40 per cent of councils not observing this structure “don’t seem to get public health”.
“My concern is that we will end up with a postcode public health system where the amount of focus on public health is very different in different areas,” he said.
Professor Ashton said he was particularly concerned about council structures in which the director of public health reported to the director of adult social care.
“This approach suggests these councils don’t understand that the wider determinants of health sit across all departments including economic development, recreation and education, not just social services,” he said.
When he introduced public health reforms in 2011, former health secretary Andrew Lansley told MPs it was his “expectation” that directors of public health would report directly to council chief executives.
This was followed by Department of Health guidance, endorsed by the Local Government Association, that said all councils should make sure their public health director was accountable directly to the chief executive.
The faculty’s research, carried out using the Freedom of Information Act, also found 76 per cent of directors of public health had access to elected members.
Professor Ashton told LGC he was pleased this figure was so high. However, he added that he had a “great concern” about the quarter of councils in which public health directors could not access councillors directly.
“Officers and members really need to work side by side on these very important issues,” he said. “If senior officers are having to go through other people to get to councillors I’m very worried about that.”
It found 38 per cent of authorities had a standalone public health directorate. Professor Ashton said that in councils that “really understood public health” it was best practice to embed the work across the council, rather than having a separate directorate.