FPH welcomes select committee public health report
The Faculty of Public Health (FPH) has welcomed the Health Select Committee report into public health.
We are pleased that the report’s recommendations address our main areas of concern about how the Health and Social Care Bill will affect public health. The recommendations now need to be backed up by our proposed amendments to the Bill, which are being debated by the Lords. This will ensure we have a robust public health system that is fit for purpose in emergencies as well as the long-term.
In particular, the Select Committee makes a vital recommendation that the government reviews its opposition to compulsory regulation of public health specialists. FPH has put forward such an amendment because the public needs to be able to trust the people who make life-or-death decisions about their health. Our members support regulation so that all public health specialists can be held to account.
FPH’s main areas of concern are about:
- The regulation of all public health specialists so that the public is properly protected
- Public health expertise being embedded in all commissioning, especially the NHS Commissioning Board
- Making sure that Directors of Public Health have the right seniority to maximise health gains for their local communities, and give them access to vital information and contacts
- Clarity over who is responsible for managing emergencies and outbreaks
All public health specialists should be registered by law to protect the public
The public needs to be able to trust the people who make life-or-death decisions about their health. That could be a decision about whether to immunise children, or how to deal with a disaster such as flooding or a swine-flu outbreak. Fortunately, a public health specialist has not yet made such a serious error of judgement that an unnecessary crisis has occurred. We should not wait until such a crisis occurs before holding all specialists to account. As part of this regulation, the Bill needs to define what a public health expert or consultant is. In effect, this is an extension of existing regulations for public health doctors and dentists.
The NHS Commissioning Board needs at least one member who is a public health specialist, to ensure the public’s health is protected
The NHS Commissioning Board will be nationally accountable for the outcomes achieved by the NHS. It is vital that national decisions about NHS services have the input of public health specialists who understand about commissioning for whole populations. Otherwise, there is a risk that the health of entire communities will be put at risk, particularly people who are hard to reach.
Directors of public health need direct access to senior leaders
Under the Bill, Directors of Public Health (DPHs) will be employed by local authorities. DPHs will need direct access to senior local leaders to drive through public health gains for their community. That is why FPH believes DPHs must be appointed as chief officers at a corporate or strategic director level, such as that of Director of Adult Social Services. The DPH also needs to be able to influence commissioning decisions made by GPs to make sure local people get the right services.
It needs to be clear that local authorities are responsible for public health outbreaks or emergencies
It is not explicit in the Bill that local authorities should be responsible for ensuring that outbreaks and emergencies are properly managed. Public Health England, the NHS and local authorities should have a duty to co-operate. We need clarity on this to avoid putting the public at risk of serious harm.
Written: 04/11/2011 , last modified: 06/02/2012