The UK Experience by Malcolm Morley *
Local Government in England was established after Dr Snow made the connection between the polluted water from the Broad Street Pump in London and ill health. Thus was born the Sanitary Inspector, which evolved into the Public Health Inspector and then into the Environmental Health Officer. Despite its importance to the public’s health and the evolution of the role to embrace many of the aspects of the environment and modern lifestyles, Environmental Health has remained largely a Cinderella profession in England.
Finally struggling from out of the grasp of Medical Officers of Health in 1974, it has not received the status and recognition it deserves for its achievements and role.
The reasons for this failure are threefold. Firstly, the major emphasis in England continues to be on curing ill health rather than preventing it. The second is that status is equated with the size of the departmental budget, and the third is the domination of the traditional professions. Doctors, lawyers and accountants are given automatic status and recognition.
It is still unusual for Environmental Health to be a separate department in Councils and consequently there are few Environmental Health Officers (EHOs) with Chief Officer status. The more specialities the service has developed, the more fragmented the service has become, with parts of it often transferred to other departments.
The more successful EHOs in England have been able to put their roles within the context of the objectives and priorities of their Councils and the Government. Metaphorically, they recognised that they may have been the best tango dancers in the world but as the only music playing was a waltz and they couldn’t change the music, they had a problem!
To take the service forwards requires managers with the vision and ability to put Environmental Health within the strategic context of their Councils and Government. Too few of these managers currently exist.
In England there has been a chronic shortage of EHOs for years. This shortage has led to the introduction of Technical Officers (TOs) to undertake many aspects of the EHOs’ traditional role.
Rather than welcome this opportunity to evolve professionally, many EHOs have resisted the introduction of TOs. Consequently, too often Environmental Health has been perceived by potential recruits as low status and as undertaking low level work.
Similarly, EHOs, being mostly employed by small District Councils, have suffered from the increasing need for specialist knowledge without the volume of work (or budgets) to justify the appointment of specialists. Rather than seek to cooperate with other Councils to share resources and expertise, they have often sought to continue as little islands and have suffered as a result.
If EHOs are going to make it to the ball as a guest rather than to check the safety of the food handling processes, there needs to be fundamental change – change in thinking, change in how Environmental Health is organised and change in how EHOs are trained and developed. The big question in England is: Are EHOs and their professional body prepared and able to think differently and to change?
* Malcolm Morley is a Strategic Director of South Oxfordshire District Council. This is one of a series of articles he is writing covering trends in the United Kingdom. He may be contacted by email at Malcolm.Morley @southoxon.gov.uk
The views expressed in this article are not necessarily those of his employer.
