The role of Public Health Officials

Both nationally and locally these erudite characters have come to the fore, standing alongside the ‘rabbits in the headlights’ politicians, to describe and explain what is going on.

These people have now entered the public consciousness, and we need to ask ourselves questions about their role in our public and private life.

When living and working in Oxford I had a colleague who was an epidemiologist, who liked to joke about having the most obscure of professions. Not any longer!

The first significant legislation on Public Health was the act of 1875, introduced by Disraeli after many years of campaigning by reformers of many kinds concerned about the everyday consequences of the unregulated growth of urban industrial life. In introducing the legislation Disraeli argued for ‘health above everything’.

The main purpose of the Act was to coordinate a nationwide response to the insanitary conditions in which most people lived, town and country.

Conditions that led to many threats to health, especially cholera and typhus, and, killers that ‘ignored’ social class. This was to be the great era of sewers, fresh water, and some regulation on housing conditions.

Of course the burgeoning middle classes had increasingly fled the suburbs, using trains to travel in to work.

Local Authorities appointed public health officials, invariably crusading physicians determined to use this legislative spotlight to transform everyday lives.

The drive to build sanitary dwellings for the labouring classes became a high priority for both national and new local governments.

Housing legislation after 1918 attempted to address the slum conditions in which most working class families lived. When William Beveridge (A Liberal academic) wrote his report (1942) he highlighted the five evils to be tackled by the ‘welfare state’ that would replace the wartime state.

Those five evils; want, disease, ignorance, squalor, and idleness, formed the ‘building blocks’ on the road to reconstruction of a society enabling citizens to have a decent standard of living and an acceptable quality of life. A state monitored life from ‘cradle to grave’.

When Aneurin Bevan became minister of health in Atlee’s 1945 government, he was also minister of housing, indicative of the enduring link between these two aspects of our everyday lives.

So, what of our rediscovered local public health officials? What are their roles and guidelines? The Health and Social Care Act 2012 set out the main statutory duties for public health by local government.

These duties are not that surprising, for example ensuring the improvement of public health, reducing the differences in healthiness between social and cultural groups, and ensuring healthier lifestyles.

This list of duties emphasises much more the preventative aspects of health care.

Devon has a Health and Wellbeing Board, a forum of key leaders from health, social care and public health, formally constituted in 2013. Setting priorities for the sector, and encouraging joint and joined up working is seen as crucial.

The Devon annual public health report 2019-20 also emphasised the challenges of climate change and a greater focus on a sustainable environment.

An essential link, and relationship, between public officials in local and national government, and the NHS was reinforced. The Act also required local government public health officials to prepare for and respond to health emergencies, and dealing with immunisation schemes. So, how are we doing? How many people in 2012 could have anticipated where we are now?

Devon County Councils Public Health team is led by Professor/Dr Virginia Pearson, and Steve Brown, with other officials in supporting roles.

The EDDC lead on Sustainable Homes and Communities is Councillor Megan Armstrong.

For now, all of these officials, and politicians at all levels of government, are very focused on the pandemic. It will be interesting to see how they all develop this current level of exposure in the coming years.