Directors of public health (DsPH) are playing a key role in the local response to COVID-19 in every community across the UK.
Rolling our sleeves up, DsPH have had to support colleagues in making sense of the ‘Made in Westminster’ policies, programmes and guidance on testing, personal protective equipment (PPE), supporting the care sector, and shielding and supporting the vulnerable. It’s a role that includes that of translator and communicator, pragmatic implementer, and developer when the promised doesn’t transpire. It has absorbed huge time, energy and resources for public health teams and other colleagues in local government, much of it really unnecessarily.
We could have, needed to have, done this so much more efficiently. The question it poses is: why not involve DsPH from day one? We know epidemiology and are experienced in outbreak management; we know data, intelligence and modelling; we understand our communities; we know our local systems and we know what works on the ground for the people we serve.
Yet, the instinct of Westminster during this pandemic has too often been command and control - but not in a good way. The correct emergency command and control structures and routes were not used. We should have asked ourselves at the beginning: what do we need to do and how can we draw on the strengths of every partner in this national effort to achieve the best possible outcomes?
As the Government charts a way forward beyond the first phase of COVID-19, there is an opportunity to reset the local, regional and national relationship. The litmus test of this will be the crucial issue of contact tracing, which will be an essential component of containing the spread of COVID-19 for the foreseeable future. DsPHs – and their teams - have extensive experience of leading and undertaking this work. This voice must be at the heart of discussions about the design and implementation of any new system so that it functions effectively and is joined up to other programmes, such as testing and supporting vulnerable people.
The Government has spoken of ‘our heroic public health workforce’. There are positive signs that ministers are increasingly recognising the role of public health after many years of undervaluing it and cutting our funding.
Now more than ever, we need deep and meaningful collaboration between Whitehall and town halls. For our part, DsPH will continue to be as constructive as possible and as challenging as necessary.
Dr Jeanelle De Gruchy is president of the Association of Directors of Public Health