A survey by the Faculty of Public Health published today finds that there are 22 per cent fewer consultants in public health than there were in 2003.

In some areas there is little confidence that there are enough do the job. In England only 36 per cent of primary care trusts (PCTs) believe that they have sufficient capacity to deliver public health effectively — and in the East Midlands, the worst-affected area, the figure falls to only 21 per cent.

Northern Ireland, Scotland and Wales are less seriously affected but over the country as a whole only 45 per cent of respondents said their team had adequate or more than adequate capability. The numbers entering the specialty are also falling, with planned recruitment for this year running 40 per cent lower than last year.

In addition, the latest restructuring of the NHS, which envisages merging PCTs and strategic health authorities, could result in the loss of up to 150 more senior positions.

Professor Selena Gray, who wrote the report, said: “It demonstrates the urgent need for clear human resources guidance that protects consultants in public health during this next re-organisation and for increased resources for training.”

Chris Lovitt, chairman of the Faculty of Public Health’s trainee members’ committee, says: “The planned massive cuts in recruitment numbers must be reversed if the future of public health is to be secured.”

Public health’s aim is to improve the health of the whole population by education, monitoring disease, reducing inequalities and controlling hazards, and it has been a neglected area since the Department of Health focused all its efforts on the NHS.

Justin Varney, of the British Medical Association’s public health committee, said: “It is recklessly shortsighted to squeeze public health training — the very specialty that must expand to tackle the health gap between the best and worst off. In any outbreak of infectious disease or emergency, public health doctors play a key role.”

• Babies born in some parts of England are eight times more likely to die before their first birthday than those in other areas, according to the baby charity Bliss. The infant mortality rate in central Birmingham is 12.4 per 1,000 live births, against 1.5 in East Elmbridge and Mid-Surrey.

  Bliss says that the figures, taken from every primary care trust in England, show that babies in large cities in the North West and Midlands fare worst and suburban areas in the South East do best. The national average for deaths in the first year of life is 5.2 per 1,000.

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