Your browser is no longer supported

For the best possible experience using our website we recommend you upgrade to a newer version or another browser.

Your browser appears to have cookies disabled. For the best experience of this website, please enable cookies in your browser

We'll assume we have your consent to use cookies, for example so you won't need to log in each time you visit our site.
Learn more

Joint public health and social care posts are not the answer

  • 1 Comment

The Faculty of Public Health recognises the dire financial situation that local authorities are placed under, and the importance of integrating health and social care.

But putting directorates of social care and public health under the leadership of someone from a social care background is not the answer.

Social care is overwhelmingly about dealing with social challenges once they have arisen.

It is akin to the NHS focus on disease rather than the public health focus on prevention.

The natural links with public health in local government are in environmental health, housing, trading standards, education, recreation and regeneration.

It is easy to see how the movement of monies between these budgets will be a natural progression, with serious implications for the public health ring fenced grant

None of these skills are usually to be found in those who head up social services departments.

Indeed the lack of such formal training programmes for those who head up social care should be a matter of much concern.

These areas are all part of the five-year training programme that public health specialists complete to a high level of competence, and which give them the skills to assess local health needs and assets, to undertake epidemiological, statistical and policy analysis and to deliver and evaluate evidence based interventions for health and wellbeing.

Modern public health consultants have a strong understanding and working links with many agencies and bodies including those from across local government which make a contribution to public health.

The faculty is also concerned about the consequences of the same person managing the social care and ring fenced public health budget.

It is easy to see how the movement of monies between these budgets will be a natural progression, with serious implications for the public health ring fenced grant.

It is very important that the director of public health is able to present a robust and independent voice for public health, a function with historical roots that reach back over 150 years.

It is vital that the director of public health is free to present an independent public health report on the state of the health and wellbeing of the local borough to the full council, with the media present.

This report is akin to that of the district auditor.

The director of public health must have the ability to present arguments that may be uncomfortable for elected members or others if we are to have a robust and effective public health function.

John Ashton, president of the Faculty of Public Health

  • 1 Comment

Readers' comments (1)

  • I am the Director of Public Health for Havering and I report directly to the Chief Executive and also sit on the Council Management team with three other directors. I chose this job in part because I had a seat at the top table and I am pleased so far with the result.

    There is a real tension which must be managed. Councils make often hard decisions on allocations of resources. The deep budget cuts that are coming to local government are a case in point. They will cause harm and affect public health.

    So after I present arguments on this that may be uncomfortable for elected members or others (and which mostly they actually understand quite well) and a budget still is not there to do the right thing, what is my next step if they do not listen or agree - or what if there is no easy or obvious solution? I can tie myself to the railings (those who know me know that I would be quite prepared to so if required). But I might also choose to stand alongside council colleagues in doing the best with what we have. I might be part of messy and difficult decisions.

    I signed up to be an independant voice for public health. I also signed up to be a manager and a decision maker.Yes it is true that public health training imparts the skills to "assess local health needs and assets, to undertake epidemiological, statistical and policy analysis and to deliver and evaluate evidence based interventions for health and wellbeing." It is also true that other Directors of Council services may not think that way as a default, although I have found my colleagues to be open to it and also good at challenging back with the "so what" question.( for example why spend all the money weighing children if we have no way of doing something about it, or why screen for dementia if our local services are not there to pick up the results?)

    I think that challenge is good for public health which does get frankly a bit precious sometimes. Our precious independant annual reports are often so boring that noone reads them anyway. We are not the only ones wearing white hats in the health and social care economy.

    Back to the core skills above. They only take us part way. Directors of Public Health will need a lot more than this in their armoury to have an impact. Is public health training fit for purpose in the new world? Am not so sure. I think it needs changing.

    Unsuitable or offensive? Report this comment

Have your say

You must sign in to make a comment

Please remember that the submission of any material is governed by our Terms and Conditions and by submitting material you confirm your agreement to these Terms and Conditions.

Links may be included in your comments but HTML is not permitted.

Related Jobs