Education And Debate

Gagging public health doctors

BMJ 1994; 309 doi: (Published 17 December 1994) Cite this as: BMJ 1994;309:1643
  1. Sally Sheard
  1. Department of Public Health, University of Liverpool, Liverpool L69 3BX, research associate.

    On 1 April 1996 the last vestiges of public health advocacy in Britain will be abolished when the eight regional health authorities are replaced by eight analogous NHS Executive regional offices.1 The regional directors of public health and their staff will become civil servants and hence constrained in speaking out on matters of public health. One consequence will be that the directors, the leaders of public health medicine, will not be allowed to become office holders in the Faculty of Public Health Medicine.

    From its inception, public health has held a unique place in the British medical establishment. Public health doctors must often speak out against governmental and public opinion in the interest of the public health. As our expectations for quality of life and health care have increased, so has the scope for intervention in all aspects of public and private life. Thus advocacy and the right of free speech have long been intrinsic components of the public health movement, and they have been regularly attacked.

    Conflicts of the first medical officer of health

    In 1847, after the appointment of William Henry Duncan …

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