Intended for healthcare professionals

Letters Health and government policy

Directors of public health are pivotal in tackling health inequalities

BMJ 2016; 354 doi: (Published 20 September 2016) Cite this as: BMJ 2016;354:i5013
  1. Michael Craig Watson, associate professor in public health1,
  2. Sylvia Tilford, president2
  1. 1University of Nottingham, Faculty of Medicine and Health Sciences, D86, Queen’s Medical Centre, Nottingham NG7 2HA, UK
  2. 2Institute of Health Promotion and Education, Welwyn AL6 0UD, UK
  1. Michael.Watson{at}

The BMJ reports on plans for government policy to tackle health inequalities.1

The health select committee’s report is clear about why public health is important and the key roles the NHS has to play.2 However, many doctors and nurses will need training and time to deliver additional preventive advice.

The committee’s report also highlights the needs assessment skills that public health specialists can bring to commissioning. To enhance capability and capacity, we strongly believe that each clinical commissioning group must include a public health specialist on its board.3

We welcome the report’s focus on data. However, instead of concentrating on negative indicators, such as deaths, positive indicators are also needed.4 These could be used for planning, evaluation, and promoting health.

We agree that “cuts to public health are a false economy.” Furthermore, we think that funding should increase to be commensurate with the considerable issues facing the country.3 5 We have previously mentioned that directors of public health are pivotal to the health of our communities.6 However, if they are to have a substantial level of influence, they will need to be given both the power and the resources.

When the government responds to this report, it should be ambitious and should develop an evidence based, long term public health strategy that not only focuses on priorities including smoking, sensible drinking, and mental health but also prioritises the reduction of inequalities. Coordinated action in hospitals, primary care, workplaces, schools, and other settings is required. Well resourced and robust public health departments will be vital to effective action.6



View Abstract

Log in

Log in through your institution


* For online subscription