Select Committee on Health Appendices to the Minutes of Evidence


Letter from Dr Peter Donnelly, President UK Association of Directors of Public Health, to the Clerk of the Committee (PH 64A)

  Many thanks for asking me for supplementary information following the session where I gave evidence to the Select Committee's enquiry. I understand that time is short and therefore I provide you with the information which is currently to hand.

I, thus far, have 37 responses from Directors of Public Health in England and, as there are 99 Health Authorities in England, this equates with a 37 per cent response rate. Of course, some of these authorities may well be between DPHs, and thus the true response rate may be slightly higher. The overall attendance rate of English DPHs to their Annual Reviews from this sample was 56 per cent in 1998, 49 per cent in 1999 and 43 per cent in 2000. Only 59 per cent of the DPHs said that population health was a substantive item at the meeting. I find it very worrying that more than half of the English DPHs are not being asked to attend their Annual Review meeting and that population health status is appearing as a substantive item on little over half of those meeting agendum.

  This compares with the situation in Wales where there was a 100 per cent attendance at the Annual Reviews in 1998, 1999 and 2000 with population health always appearing as a substantive item on the agendum.

  In Scotland, the position shows a dramatic change with 75 per cent and 80 per cent attending in 1999 and 1998 respectively, whilst none of the DPHs were invited to attend in 2000. Population health appears on the agenda inconsistently and infrequently with only one DPH prepared to say that it had definitely been a substantive agenda item.

  You also asked me to try to ascertain something about the length of time DPHs are spending in post, and thereby try and surmise whether there was any evidence of an increased turnover. The limited data returned in Scotland suggests that current DPHs have been in post for an average of 3.4 years, whilst their predecessors were in post for an average of 9.3 years. The equivalent figures in Wales are 3.6 years for current post holders, and 2.5 years for their predecessors. In England, current DPHs average 6.0 years in post and their predecessors 6.0 years. It must be emphasised that these figures are not scientifically robust and are simply based of necessity upon a rapid email straw poll. The returns from all three countries are incomplete and the estimation of predecessors' length of service is obviously particularly subject to error. Nevertheless, it does perhaps provide some confirmation that DPHs do move on reasonably frequently. Interestingly, the most often cited cause for a change of DPH was the reorganisation of health authority boundaries. There is no doubt that during periods of reorganisation, experienced and valuable public health skills can all too easily be lost in the system. This may be a particularly relevant point to note if current rumours that the number of English Health Authorities may be reduced to as low as thirty or thirty-five have any foundation.

  I hope that this is useful. As I have said above, please take the exact figures with a pinch of salt. They are the best we could do electronically over a short time period. The incomplete nature of the returns and the lack of opportunity to clarify ambiguous responses would mean that they would not stack up in terms of a formal scientific paper. Nevertheless, I think that they may be of some interest and utility to your committee. Once again, thank you for asking me for this further information.

31 January 2001

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