ACHESON REVISITED - PUBLIC-HEALTH MEDICINE 10 YEARS AFTER THE ACHESONREPORT

The issue of communicable disease control and the role of public healt h medicine is once more of considerable concern, particularly in the l ight of recent outbreaks and NHS reorganisations. Ten years ago, follo wing similar concerns, the Acheson Report highlighted several issues w ith striking parallels to the present day. These included uncertainty over the future and role of public health medicine following repeated Health Service reorganisations. The Report recommended the expansion o f the specialty in both communicable disease control and public health medicine in general, and a more clearly defined role for public healt h medicine. Successive health authority mergers and the specialty's in clusion as part of management costs have meant that the Report's findi ngs have yet to be fully implemented. Zn fact, the establishment of pu blic health medicine consultants (CsPHM) has fallen by a quarter since 1992. A further review of the public health function is required if t he specialty is not to fragment, and if able doctors are not to be det erred from entering the specialty. Such a review should include the re moval of the specialty from management costs, and the clarification & standardisation of the roles of the Director of Public Health (DPH), C PHM and other members of the multi-disciplinary public health team, as well as identifying possible organisational locations for the public health function.