When the Health Bill was launched in January, I hadn't expected that this December, the plans for England's new public health services would still be a riddle, wrapped in a mystery, inside an enigma.
The government's ambition to reorganise the NHS led to the public health measures being included in a controversial bill. The result is that, with 15 months to go before England's new public health services go live, we still await information crucial to their planning.
Environmental health practitioners work in every sector of our economy and in every community to keep people safe and healthy and to reduce health inequalities. They work for national regulators, businesses and other organisations ensuring the health and wellbeing of workers, visitors and consumers.
Many more work for local authorities in roles relevant to environmental and public health, including health protection and health improvement. They represent the largest public health workforce in local government.
It is their knowledge, skills and experience that qualify them for the new public health frontline workforce. The CIEH has made this case to government all through 2011.
We agree with Sir Michael Marmot that health inequalities have widened instead of reduced and that we need a step-change in our approach if we are to reduce health inequalities from now on.
We agree with ministers that local authorities are best placed to give us this step change because their democratic legitimacy enables them to lead individuals, communities and businesses towards improved health and wellbeing outcomes.
We want our members to help make this step change in performance. We have engaged all year with ministers, MPs and peers as well as civil servants and our public health partners in support of the government's public health plans for England.
However, we cannot plan services without essential information about the funding that will be available, the public health workforce strategy, and clearer details from the department of the public health outcomes they want us to work for.
There remain issues to resolve around directors of public health within local authorities, and the relationship between local authorities and the new creation, Public Health England.
The NHS controversy caused the pause of the bill's passage through the House of Commons. Public opposition resulted in mass lobbying of peers and a very long committee stage in the House of Lords. It is still not clear what else about the bill may yet change, nor when the new law will be enacted.
Meanwhile, local authorities and the NHS have been losing staff, some with very valuable public health skills and experience. In the case of Environmental Health, we estimate that there has been an average cut in funding of eight per cent this year and inevitably, some staff have lost their jobs. It is difficult to motivate the very personnel who should form this stronger, more effective public health workforce going forward when key staff are leaving, and those who remain in post are looking over their shoulders.
A related concern we have is that our nation's ability to respond rapidly to severe public health threats in 2012 should not be compromised. We have a good track record of responding robustly to new pandemic or E coli outbreaks. It is vital that we keep up our guard during the transition from our existing arrangements to those planned from 2013.
So my New Year's resolution will be to press home the CIEH's support for the government's public health plans. I sincerely hope that the public health minister's resolution will be to provide us and our partners with the tools we need for the job.
David Kidney, head of policy, Chartered Institute of Environmental Health