Dr Judy Curson on being a DPH in the early 90’s

A DPH in the 'olden days'

I was asked to reflect on some of the differences a modern DPH would notice if transported back to 1991 when I took up my post, shortly after DsPH had been invented (formerly district medical officers).

DsPH were based in health, rather than in Local Authorities as in England now. Our offices were based on a site that included acute and community services as well as the sprawling mental hospital whose future closure had just come into law. The acute hospital is still there but much of the site is now housing.

The technical infrastructure was very different, relying on a pager and landlines to stay in touch when out and about – which was most of the time as all meetings of more than two people were face to face (you could only have landline telephone calls between two). There were no emails so I had a duplicate book which I used to write notes to people I could not speak to – so I had a record of what I had asked them. Of course, I could send a letter or memo which had to be typed up on a word processor by a secretary or I could send an urgent message by fax. Presentations were created using felt pens on acetate transparencies.

I managed to find my 1992 annual public health report and huge progress has been made on some areas of public health focus – yet in others the challenges remain.

Smoking: We were still discussing an EC draft directive on tobacco advertising and encouraging employers and schools to introduce smoking policies; we had a smoking room in our building (better than when I had to share a smoking office as a registrar).

Baby car seats: A survey in maternity services showed that 30% of babies were still driven home from the local hospital in their mother’s arms rather than a car seat.

AAA screening: There were already advocates for screening but no consensus on what to do about small aneurysms – a Medical Research Council trial was being set up. The national programme was finally introduced in 2009.

Immunisation rates: There were fewer ‘jabs’ on offer but overall uptake figures were over 90%. As now though, there were wide geographical/GP practice variations.

Nutrition and Healthy Eating: Rising obesity and what could make a difference were comprehensively documented, although the words ‘healthy weight’ and ‘whole systems approach’ did not appear. Rates of obesity have continued to increase.

And finally, a few things I learned along the way:

• Almost everything you will achieve depends on building trusting relationships.
• You will be more successful as the best version of yourself, rather than trying to emulate someone else.
• You cannot serve from an empty vessel; looking after yourself – and your colleagues – is vital.
• Take time to celebrate successes with your team, rather than moving on immediately to the next problem.
• In five years’ time, nobody from work will remember or care whether you attended a particularly crucial meeting you cancelled your leave for; in 25 years’ time, your children will still talk about the day you didn’t go to Chessington World of Adventures with the rest of your family.