APPENDIX 54
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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