National survey of working life in public health after ‘Shifting the Balance of Power’: Results of first survey

Abstract

'Shifting the Balance of Power' restructured public health in England by abolishing district health authorities and relocating public health in primary care trusts (PCTs). Concern at the time was focused on whether there would be adequate human and other resources available to achieve the expanded public health agenda. A survey was conducted to explore these issues. Postal questionnaire survey of a random sample of members and fellows of the Faculty of Public Health Medicine (FPHM; now Faculty of Public Health). Around 8 months after April 2002, a postal questionnaire survey was sent out to members/fellows and honorary members/fellows of the FPHM. Questions asked about current job status, perception of adequacy of resources and networks, opportunities and challenges, perception of 'job strain', anxiety and depression. The response rate was 229/357 (64%). Respondents from PCTs responded that resources were barely adequate or totally inadequate to deliver the public health agenda (83%); public health networks were said to be adequate by 32% and inadequate by 68%. The PCT respondents were significantly more anxious and depressed than respondents from universities and other organizations, and 28% reported high workloads and low discretion ('job strain'). Eight months after the re-organization of specialist public health in England, there was a substantial impact on individuals working in PCTs. Financial and human resources were perceived as lacking, and levels of anxiety, depression and 'job strain' were high. Future restructuring after 'Choosing Health' must resolve major issues in capacity and capability.