Doctors have warned that public health medicine is under threat, to the detriment of the NHS and patients.
They have criticised ‘wholesale’ reductions in medically qualified jobs in local authorities in England and cuts to public health funding.
The BMA annual representative meeting also called for recognition of the importance of public health medical executives.
Cornwall consultant radiologist John Hyslop said the professional voice of public health medicine was needed by commissioners and managers, but England was seeing the ‘unravelling’ of public health since it became the responsibility of local authorities as a result of the Health and Social Care Act 2012.
He also expressed concern about what would happen in the future as more areas sought to emulate Manchester, which has embarked on a programme to devolve health and social care.
‘In local authorities there are very few executive directors of public health to provide that voice, set the culture, and inform councillors in the new world [of devolved services].
'It’s Manchester today, then Greater Hampshire and it will be Cornwall next. It’s coming to you, and the professional voice must be there in this brave new world,' he said.
Disparity of terms
BMA public health medicine registrars subcommittee chair Lucy-Jane Davis said that public health doctors were struggling to get jobs [in local authorities] that matched NHS terms and conditions, or salaries.
She said the BMA was supportive of other members of the public health team. But Dr Davis added: ‘This isn’t about saying we’re better; it’s about valuing the diversity of what we bring and valuing what we do.’
Doctors and medical students also expressed serious concerns about whether public health doctors felt able to speak up in the interests of the public’s health because of a lack of clarity with contractual arrangements, or because of threats of disciplinary action.
BMA public health medicine committee Iain Kennedy said that employers should recognise that doctors’ duty to public health overrode any other contractual requirements.
Find out more about the BMA ARM 2015