The government will amend proposed legislation to make the role of director of public health a statutory post on the same footing as council directors of adult and children’s services.
A document on public health in local government published today by the Department for Health revealed the Health Bill would be amended so that directors of public health would be added to the list of statutory chief officers in the Local Government and Housing Act 1989.
The move bolsters the status of role follows ongoing concerns that some local authorities were seeking to appoint directors of public health at a lower management level than they currently have in primary care trusts.
The government said in its public health white paper update in July that its “expectation” was for DPHs to report directly to council chief executives, but chose not to enforce this through legislation.
The DH said today will issue statutory guidance on the responsibility of directors of public health “in the same way that guidance is currently issued for directors of children’s services and directors of adults services”.
“While the organisation and structures of individual local authorities is a matter for local leadership, we are clear that these legal responsibilities should translate into the director of public health acting as the lead officer in a local authority for health and championing health across the whole of the authority’s business,” the document stated.
“This would mean we would expect there to be direct accountability between the director of public health and the local authority chief executive for the exercise of the local authority’s public health responsibilities and that they will have direct access to elected members,” it added.
While council chief executives will be formally accountable for the ring-fenced public health grant, the document said the DH expected “day to day responsibility for the grant to be delegated to the director for public health”.
Faculty of Public Health president Lindsey Davies said she was pleased the DPH would now be “one of the most senior officers in the local authority” and that it was “encouraging to see commitment for DPHs to have a ‘clear leadership role’ in health protection”.
Association of Directors of Public Health president Frank Atherton said he welcomed the “very strong line” on public health director status.
Latest ADPH survey results suggest only 58 per cent of DPHs currently expect to report directly to council chief executives. Mr Atherton said he thought the DH’s documents would mean some councils had to rethink decisions.
He said: “It’s still down to local decisions but I think DPHs now have enough ammunition to have robust discussions.”
The document also includes an updated list of councils’ public health responsibilities. In a departure from the original plans, abortion services will now be commissioned by clinical commissioning groups rather than local authorities due to their “highly clinical, and in most cases surgical, nature”.
Meanwhile, councils will be mandated to provide sexual health services to “allow the secretary of state for health to meet [his duty to provide advice on contraception] fully, over and above what is provided for via current GP provision”.
NHS Confederation deputy policy director Jo Webber said: “The government has clearly listened to the concerns of the NHS as it seeks to turn its plans for public health into reality. We don’t have the full picture yet but this does give us an idea of the steps on the way to enacting an extremely ambitious plan.
“We cannot ignore the issues that remain. These include the funding of the new system, how powerful health and wellbeing boards will actually be in co-ordinating public health policy, and developing and retaining sufficient expertise to make the reforms work effectively.”