Who contributes to the public health function?

This paper describes the current nature and distribution of staff making an active contribution to the public health function in Health Authorities in England, so as to assess the extent to which the public health function is truly multidisciplinary and to begin to consider the National Health Service public health capability.

A pre-piloted questionnaire was administered by Regional Directors of Public Health (RDsPH) to their respective District Directors of Public Health (DDsPH) in all Health Authorities in England over the period June 1995-April 1996. The questionnaire asked for details of all staff in Health Authorities contributing to the public health function as defined by the DDsPH. This provided distributions of: Public Health Physicians; Consultants in Dental Public Health (CsDPH); Trainees in Public Health Medicine (PHM); Epidemiologists; Research Officers; Nurses; Medical Advisers; Pharmacists; Directors of Health Promotion; Others (job titles specific to public health) in Health Authorities in England.

Staff contributing to the public health function were distributed as follows: Public Health Physicians (32 per cent); Research or Information Officers and Epidemiologists (16 per cent); Trainees in Public Health Medicine (16 per cent); Nurses (8 per cent); Pharmacists (6 per cent); Medical Advisers (5 per cent); Directors of Health Promotion (4 per cent); Consultants in Dental Public Health (3 per cent); Others (job titles specific to public health) (11 per cent).

The public health function is multidisciplinary, but the skill mix within Health Authorities is variable. The contribution of all disciplines to Health Authority public health functions needs recognition, not least in the provision of training, accreditation schemes and continuing professional development for all staff so as to secure an effective public health function at local levels to deliver the health agenda.