ABSTRACT
The specialist public health profession has moved forward and specialist skills are now becoming competency based, and dependent on ability rather than on a designated professional qualification. In 1998 the structure of the English public health system was based on a network with regional and district nodes. While the creation of the Health Protection Agency (HPA) undoubtedly adds to the strength of the public health infrastructure, it further highlights the capacity problems of the public health community. Public health specialists in health protection are no longer employed and working alongside their generalist colleagues in the local NHS public health departments, thereby increasing fragmentation and stretching already scarce resources. An area of weakened practice under review is the academic sector, particularly its relationship with service public health. While joint working between the NHS and academia is recognised as essential, collaboration between academic and service public health remains problematic in many areas.
