Public health doctor England

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BMA Q and A: PHE restructure, funding and local authorities

Iain  Kennedy portrait serious 16x9

BMA public health committee chair Iain Kennedy answers your questions

How is Public Health England’s ongoing restructure affecting public health doctors?

The strategic review and cuts in its budget of around 20 per cent in 2015-16 has had profound effects on doctors working in PHE.

Much is changing and doctors are feeling fatigued and undervalued. Alterations to PHE’s regional structure will lead to a reduction in headcount of public health consultants and new ways of working for those who remain.

PHE is also consulting on changes to the delivery of its health protection functions and we have concerns that, if implemented, expert staff and resourcing will be overstretched.

Redundancies in health protection are proposed along with changes to terms and conditions covering on-call arrangements.

We are preparing a strong response to the proposals.


In 2014-15 you’ve highlighted funding problems in public health — what’s the latest position?

We have concerns that the public health grant to local authorities in England, which funds the delivery of statutory public health functions, is not being used to best effect.

The Treasury’s announcement this summer to cut £200m from the grant is a further disturbing development.

This cut has now been allocated across all local authorities and we are concerned that it is affecting delivery of frontline services.

November’s comprehensive spending review implemented a further 4 per cent cut to the grant.

Accompanying this was a puzzling message from the chancellor that these savings would ‘finish the job of reforming the public health system’, as if this were all part of
a clear strategy.

All this combined with PHE’s 20 per cent budget cut means that Government rhetoric about investing in public health to lessen demand on the future NHS seems to be just that — rhetoric.


How are public health doctors feeling about their role in local authorities?

We know from members that several local authorities are reducing public health teams or implementing unfavourable terms and conditions for medical staff, making working in local authorities less attractive.

We are advising members individually and have developed guidance for consultants.

The Commons health select committee has begun an inquiry into the effect of the 2013 reforms on public health services delivery, to which the BMA has responded.


The Faculty of Public Health is reviewing its membership exam. Is the BMA supportive?

This year, we were pleased to work with all stakeholders to look at ways to develop the Part A assessment.

The faculty now plans to implement changes recommended by the GMC and we look forward to seeing continued improvement in the exam.

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