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Half of public health doctors might leave profession

Reforms have increased bureaucracy but not public health, reports the BMA

Louise Prime

Tuesday, 18 March 2014

Huge numbers of public health staff are considering leaving their profession, shows new research by the BMA. They are worried that their terms and conditions are not secure, as well as concerned by poor work-life balance, lack of career fulfilment and an increase in unnecessary bureaucracy, shows the report.

Doctors and other public health staff also claim that the transfer in 2013 of most public health responsibilities from the NHS to local authorities and Public Health England, under the Health and Social Care Act 2012, has not benefited public health.

The BMA survey – to which 340 doctors and 250 non-medical public health professionals from across the UK responded – uncovered signs of an impending workforce crisis. It found that more than half of public health consultants, and almost half of those in training, have recently considered leaving public health. Two-thirds of all respondents believe that in ten years’ time there won’t be enough substantive consultant posts to serve the population’s needs – and nor do they think that those posts will be continue to be remunerated at at least the same level as now. More than two-thirds of LA and PHE employees said that, since the reforms moved public health to LAs, their professional support had not improved.

Respondents were also concerned about poor collaboration with other health professionals, and commissioners, on planning and delivering health care services. Fewer than half of local authority employees said that public health in their LA had good working relationships with GP practices, secondary care providers, community care providers, housing associations or their PHE Centre; however, more than two-thirds claimed good working relationships with their local clinical commissioning group and local PHE Health Protection Unit.

The survey highlighted low levels of support for England’s public health reforms – most said they had not benefited the public’s health, and that they’d led to an increase in unnecessary bureaucracy.

Dr Penelope Toff (pictured), co-chair of the BMA’s Public Health Medicine Committee, said: “Transferring public health responsibilities from the NHS to local authorities in England has led to considerable ongoing uncertainty and anxiety about the future of public health. That makes the results of this survey all the more important as an indication of the state of the current public health workforce and how they feel about the future.

“It is particularly worrying that so many public health specialists are experiencing unsupportive work environments, where they feel that their skills are not understood or valued. This report leaves us in no doubt that we will be facing a recruitment crisis, worsening the serious public health effects of austerity, such as increasing levels of alcohol and drug abuse.

“These findings demand urgent action. The public has a right to expect strong, independent voices to speak out on issues of importance to their health and all public health professionals should be supported to do the work for which they were trained. Every local authority needs sufficient experienced specialists to ensure both NHS and public health budgets are spent wisely.”

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