Introduction

For doctors, at the end of the 1990s, the standard, statutory process for achieving inclusion in the Specialist Register of the General Medical Council (GMC) and thereby becoming eligible to apply for NHS consultant posts was via satisfactory completion of specialist training in public health medicine. A similar process was introduced by the General Dental Council (GDC) for dentists becoming consultants in dental public health. This process was in line with the training requirements for all medical specialties, with each Royal College or Faculty setting its curriculum to be approved by the GMC. With recognition of public health specialists from backgrounds other than medicine it became clear that an equivalent regulatory system for assuring quality and protecting the public would be required for all those specialists who were not regulated by the GMC or the GDC.

Setting up the regulatory processes

It was recognised within the Department of Health (DH) that the creation of Director of Public Health (DPH) posts that could be occupied, from 2002, by suitably competent individuals from a wide range of professional backgrounds carried with it new risks. These included the absence of professional accreditation or recognition for non-medically qualified specialists, and, in particular, the absence of any regulatory framework.

Until then, professional regulation under the jurisdiction of the DH had been restricted to health professionals who had contact with individual patients, whose actions could be interpreted as assault if conducted ineptly or inappropriately. Specialist public health practice was distinctly different as its proponents rarely had dealings with individual patients or clients and it took some time to gain consensus on the notion that a public health specialist's impaired fitness to practise could adversely affect the health or well-being of whole communities, rather than simply named individuals.