I Need A Job

Now who would ever have thought I would say that? Here I am, a Consultant in Public Health Medicine, medically qualified, trained in Paediatrics, trained in Public Health Medicine, yet I NEED A JOB.

I never believed I would be saying that.  When I became a doctor it was kind of accepted that you had a job for life – not necessarily which job, but there would be some employment. This was possibly a bad idea, but nevertheless I was fairly convinced when I qualified that I would be in gainful employment until I retired. Actually, I held this belief until the Health and Social Care Bill (as it then was) was published.

Now it is an Act. Whether I like it or not (and I don’t!) it is law. And my job is disappearing as a consequence. Not that Mr Lansley would accept that. Oh no! He says that Public Health is being strengthened. This only demonstrates how little he understands about what the discipline of Public Health really entails (and, possibly, contains).

Public Health has three strands or pillars. There is Health Protection – protecting the public from diseases like measles, HIV, Legionnaire’s, but also exposure to dangerous things like asbestos. Then there is Health Improvement, which is what most people understand by Public Health – the things in the environment and in our life styles that cause disease, like smoking and obesity. The third aspect of public health is what we call Health Services Public Health (HSPH). It is the most difficult to explain, but it is vital to the health of the nation and of the NHS. Basically, those of us who work in HSPH analyse what is needed for the health of the population and support commissioners in providing it. We look at how well hospitals are performing; we analyse the needs of our local populations; we advise on what should be commissioned. I could go on, but I won’t, because it is hardly thrilling to read. Yet it is vital, and difficult, and highly specialised, and critical to the NHS. AND IT IS DISAPPEARING.

Which is why I say – I need a job. The job that I have done for a number of years is disappearing: not because it is not needed, but because the powers that be do not recognise its importance. Already, many of my senior colleagues have left. We cannot afford this attrition rate. Yet nobody seems to care. When you try to reinvent it – remember us.