New emerging threats agency ‘should be independent of the Department of Health’

Consultant in public health medicine Anne Dee. 'Change is difficult and to try and implement more change on top of what has been a very difficult would maybe have the potential to scupper our achievements,' said Dr Dee. Picture: UL.ie 

An agency to identify ‘emerging threats’ to the health service, such as future pandemics, should be independent of the Department of Health, a top public health consultant has said.

It was announced last month that the agency would be established following recommendations by the Public Health Reform Expert Advisory Group.

It is expected to focus on infectious diseases, pandemic preparedness, and other emerging threats to public health.

However, Anne Dee, consultant in public health medicine and chairwoman of the Irish Medical Organisation’s public health committee, said the agency has the potential to “scupper” ongoing successful reforms in the sector.

“I would be very much of the opinion that the way to achieve change through reform is to give reform time to bed in and actually see how it’s working,” Dr Dee said.

Adding more reform on top of reform is not a good thing — everybody who works in any sort of change management situation will understand that.

Public health specialists are in the midst of a changeover to public health consultant status, essentially interviewing for their own jobs among other reforms.

Dr Dee said it has been “a massive achievement” for everyone leading this from the HSE’s side but extremely challenging.

“It has been a very difficult process for people,” she said. “Going through the interview process, there’s been a lot of successful candidates but there’s also been a lot of disappointed candidates at various levels.”

These ongoing reforms were long-discussed and gained traction when public health doctors were so central to tackling covid.

“Change is difficult and to try and implement more change on top of what has been a very difficult would maybe have the potential to scupper our achievements, and I would be a bit worried about that,” she said.

A proposal on the scope and functions of the emerging threats agency is expected to be brought to Government within six months of the September announcement.

The expert group, chaired by Hugh Brady, recommended creating “a new independent public health body, Public Health Ireland, which sits under the aegis of the Department of Health, with a legislative mandate”.

However, Dr Dee raised concerns about locating the new agency within government, querying how independent such an agency could be. She said: 

I think to politicise public health, which is meant to be a broker, the honest broker in health would be a very bad move. 

“So to have the public health agency in the Department of Health would really be a bad thing.”

Instead, she said, reforms should focus on what is already being built.

“It would be my opinion that the best place for a public health agency to be effective is within the health service,” she said.

“From my point of view, what we have done with reform is effectively set up a public health agency within the HSE but not call it that.

“This [new agency] has the potential to be a good thing but it also has the potential to be quite disruptive to the whole process.

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“So I’m very hopeful that a sensible approach will be taken, and that reform will continue and be strengthened and in no way undermined by any other agencies being established.”

Since 2021, some 40 public health consultant posts have been filled. It is understood another 15 are in the recruitment process out of 84 to be offered in total, with advertising for the remaining posts expected to be complete by year’s end.

Also, 242 staff have been hired and an additional 89 staff allocated to the Health Protection Surveillance Centre to boost the national infectious disease surveillance system.