Ian Andrews looks at the place of environmental health teams at a time of local government reorganisation and devolution.

In 1943, the onset of the use of penicillin as an antibiotic offered both the British and American armies the opportunity to counteract infection in battle wounds and to cure other infectious diseases. Let us call this a “43 moment” from a health point of view. Whilst supply was limited, particularly to the British, the drug was a helpful "shot in the arm". As parts of England consider the consequences of the Government's plans for devolution, alongside local government reorganisation in 21 counties, there is a pressing need for certain professions to be given a "shot in the arm" if current Government aspirations are to be deliverable. 

The introduction of the English Devolution and Community Empowerment Bill into Parliament comes at a time when budget cutbacks have had a chronic effect on  professional workforces. For a less visible workforce, like environmental health, these effects have been tangible, even though the Covid-19 pandemic offered a clear opportunity for the profession to demonstrate what it was capable of, and what a fundamental part of the public health workforce they are.

Environmental health as a discipline enables people to exist in an environment where risks to their wellbeing are identified, explored, and mitigated, but there aren't enough Environmental Health Practitioners (EHPs) around, or being trained, to work within new local government structures to provide advice and take action to protect the wellbeing of different communities. Where environmental health teams will sit in the as-yet-undecided unitary and strategic authority structures, and how they will support the strategies of regional mayors, is all up for debate, such is the connectedness of environmental health. The Chartered Institute of Environmental Health (CIEH) believes they should be closely aligned with public health teams because of obvious legal linkages.

The Bill gives us a modern ’43 moment’ in the form of Clause 43, which focuses on health inequalities and public health. Two amendments to this clause were tabled by MPs at the Bill’s Committee Stage. These would have served to raise the profile of particular environmental health issues, and thus the value of the profession. One amendment sought to add certain "environmental harms" onto a list of general health determinants that would be mandatory for new strategic authorities to consider; the second amendment was more specific and adopted complementary wording. The government’s response to the amendments was that the clause was written to encompass a wide number of general health determinants and that the Environment Act 1995 already requires combined and county combined authorities to work with local authorities on air quality plans for their areas.

Whilst neither amendment was carried forward, it shows that there is a background desire for more action and recognition of impacts from low air quality standards and other environmental harms. The call for air quality to be a basic human right (known as “Ella’s Law”) is but one “harm” where there are legal developments to watch. Environmental Health Officers - as they are known in local government structures - understand these harms in depth and are able to adopt advisory or enforcement tactics to minimise their impact on different communities of climate change.  

As devolution and restructure plans are developed and rolled out over the next few years, the Chartered Institute of Environmental Health (CIEH) are very open to engaging with different decision makers at the unitary, strategic and national level to help influence and support change. As a professional body, we want to see environmental health, and thus public health outcomes, high up on the agenda, just as the fitness of soldiers was a pressing concern at a previous ‘43 moment’ and penicillin was used to achieve that long term objective.

Ian Andrews is Head of Environmental Health at the Chartered Institute of Environmental Health.