1.  THE ROLE OF THE PUBLIC HEALTH MEDICINE ENVIRONMENT GROUP

  The Public Health Medicine Environment Group (PHMEG) is the professional body representing and supporting Consultants in Communicable Disease Control (CCDCs), epidemiologists and other specialists working to protect the public health throughout the UK. It is an affiliated Expert Group of the Faculty of Public Health Medicine.

2.  PUBLIC HEALTH DUTIES OF CONSULTANTS IN COMMUNICABLE DISEASE CONTROL

  CCDCs are usually Health Authority based public health doctors responsible for the co-ordination of infection control at population level, including the overall co-ordination and development of immunisation, and responsible for the investigation and management of communicable disease outbreaks and incidents, and infectious disease surveillance. Delivery of this function requires effective liaison across local organisations such as Local Government, Public Health Laboratory Service, NHS Trusts, and Primary Care as well as the co-ordination and management of a range of public health programmes. Most CCDCs hold Local Authority appointment as their "proper officer" for the purposes of public health legislation.

  In managing specific infectious disease and environmental incidents, implementing national policy and running public health programmes at a local level, CCDCs also work through national agencies such as the Department of Health, MAFF, Health and Safety Executive and Environment Agency in order to achieve their purpose of public health protection.

  Most CCDCs have a broader health protection role which entails health authority responsibility for environmental health issues, emergency planning/response, district immunisation co-ordination, local HIV/AIDS co-ordination. These services are delivered through a range of public health programmes, which include some specialist commissioning, to involve local organisations and people and to target health problems, risk groups and inequalities.

3.  THE PUBLIC HEALTH PROTECTION ROLE OF CCDCS

  National and regional surveys on the CCDC function show that in many health authorities there is an inadequate infrastructure, in terms of clinical, public health and administrative staff, to support this statutory function. Moreover, failure to fully implement the Acheson Report (1988) recommendations, to give CCDCs executive responsibility for health protection and decision-making authority, in the interests of public health protection across a wide range of agencies, has limited their effectiveness and influence at local and national level.

4.  RECOMMENDATION FROM PUBLIC HEALTH MEDICINE ENVIRONMENT GROUP TO HOUSE OF COMMONS SELECT COMMITTEE

  CCDCs need the executive authority to enhance their role in the changing NHS and public health infrastructure. Their expertise and influence in the planning and implementation of programmes to protect health, improving it where possible, cannot be further compromised or lost. Their relationship with Directors of Public Health needs to be reviewed.

  The PHMEG would be pleased to give oral evidence to the Select Committee.

July 2000