By John F Crawford, environmental health officer and past president of the Royal Environmental Health Institute of Scotland

MOSES was said to be the first public health officer. Faced with leading a large community across the wilderness (at a time when pork was infested with tapeworm) he set out rules for minimising outbreaks of infectious disease. Today many of his rules have been overtaken by time and circumstance, but communities still need access to clean food, water, air and efficient waste collection and disposal services.

Our public health protection traditions began in the Victorian age due to rapid expansions in the cities. The Burgh Police (Scotland) Act 1892 and The Public Health (Scotland) Act 1897 were consolidations of earlier legislation. By the 1920s the appointment of chief sanitary inspectors in our cities, counties and burghs had to be approved by the Secretary of State for Scotland, who paid a proportion of their salaries to prevent politicians from meddling in public health matters or sacking the individual concerned.

This situation continued until the 1975 reorganisation when the new Scottish district councils had to set up separate environmental health departments with their own directors. There followed the halcyon days of the service with an all-graduate profession from the mid-80s coupled with specified on-the-job training. Environmental health directors were members of their councils, senior management teams and had the ears of the senior politicians. Councils made a lot of investment in training environmental health officer (EHO) students who then worked all over Scotland and further afield in both the private and public sectors. And to some extent, the EHOs afterwards became a victim of their own successes as coupled with improved standards of nutrition, better healthcare and housing, the traditional work of the EHO focused more on food safety, health and safety and pollution control. The sale of council houses together with a reduction in rented housing meant less involvement in identifying sub-standard properties, slum clearance and so on.

But new problems emerged such as noise complaints, food quality issues and the like as more people dined out as well as an exponential increase in car ownership. But by the next reorganisation in 1996, there had been no significant outbreaks of communicable disease in Scotland (such as the typhoid outbreak in Aberdeen in the early 1960s) and complacency crept in. So the new unitary councils formed in 1996 weren’t given a template for their organisational structures apart from merging the services delivered by the former Regions and districts. Since 1996 most councils now have a very small number of multi-disciplinary departments headed by directors who can’t be expected to understand every aspect of the services they’re responsible for delivering. The last published research (nearly a decade ago) indicated that in many councils the most senior qualified EHO is at best at third tier level: not really well-placed to influence council policy.

The most worrying thing however is that training posts have been ruthlessly cut since the turn of this century, the usual excuse being ‘pressure on budgets’. But recent research shows that 47 per cent of the EHOs currently working in Scotland are over 50 and there aren’t enough trainee posts to fill the gaps created when they’ll retire. It takes four years (assuming the practical training is undertaken in university recesses) to become a qualified EHO and there are no short-cut routes to qualification so why hasn’t Scottish Government and Cosla (who’ve both known about this problem for more than a decade) not instructed the councils to take on more trainees? Will it take another outbreak such as occurred in North Lanarkshire some years ago before something is done?