"We must fight for a professional environmental health service"- Letters to The Herald

A couple of letters have been printed in The Herald newspaper regarding the current concerns over the Environmental Health profession. 

John Crawford past president of REHIS wrote a letter titled “Agenda: Councils must give more prominence to role of environmental health” and was published 13th August 2018. Tom Bell, Chief Executive of REHIS replied to this letter titled “We must fight for a professional environmental health service” and was published on 3 September 2018. 

Both letters can be read below. 

Agenda: Councils must give more prominence to role of environmental health

By John F Crawford, environmental health officer and past president of the Royal Environmental Health Institute of Scotland

“Moses was said to be the first public health officer. Faced with leading a large community across the wilderness (at a time when pork was infested with tapeworm) he set out rules for minimising outbreaks of infectious disease. Today many of his rules have been overtaken by time and circumstance, but communities still need access to clean food, water, air and efficient waste collection and disposal services.

Our public health protection traditions began in the Victorian age due to rapid expansions in the cities. The Burgh Police (Scotland) Act 1892 and The Public Health (Scotland) Act 1897 were consolidations of earlier legislation. By the 1920s the appointment of chief sanitary inspectors in our cities, counties and burghs had to be approved by the Secretary of State for Scotland, who paid a proportion of their salaries to prevent politicians from meddling in public health matters or sacking the individual concerned.

This situation continued until the 1975 reorganisation when the new Scottish district councils had to set up separate environmental health departments with their own directors. There followed the halcyon days of the service with an all-graduate profession from the mid-80s coupled with specified on-the-job training. Environmental health directors were members of their councils, senior management teams and had the ears of the senior politicians. Councils made a lot of investment in training environmental health officer (EHO) students who then worked all over Scotland and further afield in both the private and public sectors. And to some extent, the EHOs afterwards became a victim of their own successes as coupled with improved standards of nutrition, better healthcare and housing, the traditional work of the EHO focused more on food safety, health and safety and pollution control. The sale of council houses together with a reduction in rented housing meant less involvement in identifying sub-standard properties, slum clearance and so on.

But new problems emerged such as noise complaints, food quality issues and the like as more people dined out as well as an exponential increase in car ownership. But by the next reorganisation in 1996, there had been no significant outbreaks of communicable disease in Scotland (such as the typhoid outbreak in Aberdeen in the early 1960s) and complacency crept in. So the new unitary councils formed in 1996 weren’t given a template for their organisational structures apart from merging the services delivered by the former Regions and districts. Since 1996 most councils now have a very small number of multi-disciplinary departments headed by directors who can’t be expected to understand every aspect of the services they’re responsible for delivering. The last published research (nearly a decade ago) indicated that in many councils the most senior qualified EHO is at best at third tier level: not really well-placed to influence council policy.

The most worrying thing however is that training posts have been ruthlessly cut since the turn of this century, the usual excuse being ‘pressure on budgets’. But recent research shows that 47 per cent of the EHOs currently working in Scotland are over 50 and there aren’t enough trainee posts to fill the gaps created when they’ll retire. It takes four years (assuming the practical training is undertaken in university recesses) to become a qualified EHO and there are no short-cut routes to qualification so why hasn’t Scottish Government and Cosla (who’ve both known about this problem for more than a decade) not instructed the councils to take on more trainees? Will it take another outbreak such as occurred in North Lanarkshire some years ago before something is done?”

The letter can be read on The Herald website here.

We must fight for a professional environmental health service

By Tom Bell, Chartered Environmental Health Officer, Chief Executive, The Royal Environmental Health Institute of Scotland

“I read with interest John Crawford’s recent informed Agenda article ("Councils must beef up environmental health, The Herald, August 13). Although now retired from senior environmental health and waste management posts within local government and from lecturing on environmental health at the University of Strathclyde he remains an influential and highly respected voice within Scotland’s environmental health community.

Environmental health officers (EHOs) are educated, trained and qualified to protect and improve the health of Scotland’s people from adverse health effects that they encounter day and daily from the environments they live and work in. They are generalists on qualification and deemed competent by the institute following academic success on an accredited BSc (Hons) Environmental Health degree course, on the institute’s Scheme of Professional Training and in the institute’s professional examination for the Diploma in Environmental Health.

Local authorities, the home of the service for around 150 years, have been actively shedding EHO posts, along with food safety officer and technical support staff posts, since local government reorganisation in 1996. The situation is now critical.

With the reduction in EHO posts came the reduction in the number of training placements for student/graduate trainee EHOs within local authorities. School leavers realising that career paths into the profession are now few and far between realise that a future career in the service is, at best, uncertain and opt to follow different careers with the result that degree courses struggle to remain viable. In the past few years three courses accredited by the institute (the BSc Honours degree courses at the universities of Edinburgh and Strathclyde, and the MSc degree course at the University of Strathclyde) have closed due to the lack of students. Only one degree course accredited by the institute, the University of the West of Scotland) is currently presented in Scotland.

Working groups have been convened, seminars presented, reports published, articles written and questions asked at the Scottish Parliament on the future delivery of the Environmental Health Service in Scotland. All outcomes have pointed to the importance of the profession and the local authority-based service to the protection and improvement of public health but when it comes to resolving the issues no one organisation has full autonomy to turn the situation around.

Local authorities are cash strapped and the environmental health service is one of many struggling to deliver. The Scottish Government and Cosla have been discussing the wider issues surrounding improving the health of Scotland’s people and how the various services can co-operate to deliver improvement but progress appears to be slow.

The Scottish Government’s ongoing review of the public health function has identified the environmental health service as a core contributor to the delivery of public health. However, for the service to positively influence public health EHOs and the service will have to be placed at the centre of the decision making process within local authorities and not be left on the periphery being viewed solely as regulators and not as key public health professionals with a wide range of professional competencies all of which are geared towards carrying out interventions which will more effectively improve and protect public health in Scotland.

The outcome of the ongoing deliberations between all interested parties is awaited with optimism.

The question our politicians and society as a whole need to ask themselves is: how much do we value a properly resourced competent environmental health profession and service and support them to continue to effectively protect and improve the health of the public on the frontline?”

The letter can be read on The Herald website here.

REHIS is a registered charity in Scotland, SC009406

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