Speech from the Chairman of the Public Health Medicine & Community Health Committee
Dr Peter Tiplady
Tuesday 29 June 2004
Conference,
The section allocated directly to public health issues is short and there are rather important issues and matters to be debated, so this speech should be short.
Public health continues to be plagued by change.
After many years of building up strong well-staffed, well-resourced departments, public health was deconstructed and distributed around something like five times as many PCTs as there were health authorities.
About one in five PCTs has not yet appointed a director of public health in spite of opening up the post to non-medically qualified specialists in Public Health.
Public health doctors working in the primary care trusts are often isolated professionally and lack support, and I am very concerned about the effect this is having on morale in the craft.
Only a couple of years ago I learned of a DPH who has resigned his post without somewhere else to go to.
In spite of these difficulties, Public Health Doctors are doing a tremendous job and here I pay tribute to their hard work in the trusts and the quality of service they provide.
The next change in the system will be that Primary Care trusts will be amalgamating and departments of public health could once again be strong.
Change however is always difficult and it is likely that large numbers of doctors only recently appointed as directors of public health will be competing for one of the new posts.
The central committee will ensure that this process is as open and as fair as we can achieve and that our members are not compromised either professionally or financially.
The increased emphasis on Public Health in the Wanless Report is welcome.
Government can do much more to strengthen the health of the nation and we will among other things continue to press for legislation to prohibit smoking in enclosed public spaces.
It is very fitting that the current BMJ has the final study by Sir Richard Doll and a reprint of his first of 50 years ago.
We owe Sir Richard an enormous debt for the work he has done which gives us the evidence and the courage to take our stand on the burden of disease due to cigarette smoking.
The Government really must put its money where its mouth is and increase resources in public health if it wants to see progress.
The Faculty of Public Health has published a manpower study which highlights the need to increase staffing levels in Public Health considerably.
We have not even reached the target levels recommended several years ago by the Acheson enquiry.
The committee has prepared a vigorous commentary on the recent consultative document "choosing health", which supports patient choice but underlines the government role in ensuring that there are mechanisms in place to ensure that people can make those choices.
I expect that this paper will be available on the website.
After many years of supporting the fluoridation of the public water supply, progress has at last started to happen.
The Private Member's Bill sponsored by Andy Burnham MP has amended legislation so that water providers will be required to fluoridate the water to one part per million, on request by the health authority, only after a proper consultation has taken place.
The CCPHMCH supports a democratic consultation process and our members will be involved in providing information to the public and assisting them to make informed decisions.
I would like to pay tribute to Sue Marks of the Parliamentary Unit who has been enormously influential in this process and has worked closely and effectively with members of both Houses of Parliament and with all the professional organisations supporting fluoridation.
I truly believe that without her contribution this process may not have been achieved.
It certainly would not have been as smooth.
I am also delighted that the Chief Medical Officer for England and Wales, Sir Liam Donaldson, has appointed Dr Fiona Adshead as Deputy CMO with responsibility for public health.
I look forward to meeting her and to a closer involvement of my committee with the Department of Health.