Public health expertise losses begin to bite

An overwhelming majority of directors of public health have seen their teams affected by unfilled posts as a result of budget tightening and uncertainty over the transition from primary care trusts to councils scheduled for April 2012.

Association of Directors of Public Health chief executive Nicola Close told HSJ that 85 per cent of directors reported unfilled posts in their teams in a survey carried out by the association in April, the results of which have not previously been made public.

Additionally, nearly half of the 80 directors who responded to the survey said their teams had been reduced by redundancies.

Last week the Commons health committee’s public health inquiry was warned about a loss of local public health skills. A Department of Health letter also acknowledged more uncertainty for staff at strategic health authorities and the Health Protection Agency in the wake of the decision to delay their abolition until April 2013.

Concerns have also been raised by the Faculty of Public Health about a shortage of posts for public health medical trainees and warnings of staff leaving public health observatories.

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David Goldblatt, a member of the influential Marmot review of health inequality and a senior research fellow at University College London, told the Commons health committee the “two year interregnum” was “seeing a loss of public health expertise at local level”, which would take “time to regain”.

In its written evidence to MPs, the Marmot review team said councils in some areas were drawing up plans to make public health leads answerable to social services directors, rather than council chief executives.

Ms Close said this could prove a “deal breaker” for those affected, leading to further loss of expertise.

Meanwhile, the government last week announced that the formation of Public Health England will be moved back by a year to April 2013 to maintain “coordinated and robust” public health arrangements during the Olympics, as part of its reform amendments.

Chief medical officer Dame Sally Davies and Public Health England transition lead Anita Marsland said in a letter last week they recognised the timetable change would “bring some challenges and create further uncertainty for staff affected”.

However, they also promised a “Public Health England people transition policy in the autumn” and said work was underway on a “concordat” between the NHS, DH and local government dealing with the transfer of staff.