Member blog: Dr Allison Duggal

As many of us face election uncertainty, reductions in ICS staffing, and the usual grant -wrangling of the new financial year it helps to consider where our profession has come from and where it is going. 

Our heritage

Public health has roots in the social reform of the nineteenth century. Pioneers such as Chadwick highlighted the links between poverty, sanitation, and ill health while Florence Nightingale demonstrated what could be achieved with data. Those early reforms — from clean water and sewerage to housing and workplace standards — fundamentally reshaped life expectancy and laid foundations for the welfare state and NHS.  

The here and now

As Directors of Public Health (DsPH), we lead systems simultaneously, managing the consequences of the pandemic, widening inequalities, ongoing financial constraint, workforce pressures, and an increasingly volatile national and global context. As the so-called Chinese Curse goes – “May you live in interesting times”.   

Like most DsPH, this was not my original career aim.  A junior laboratory scientist lucky enough to be supported through a degree and PhD, I intended to stay in the lab. But life had other plans and I moved to London (Yes – still there and commuting to Coventry) and became a health and safety inspector. A sideways move into infectious disease policy led ultimately to public health training.  Like colleagues elsewhere I brought this experience of research, policy development, and scientific rigour along with me into the public health workforce. 

The place‑based nature of the role is particularly important to me. Leading public health in Coventry means understanding the city’s history, diversity, and strengths, as well as challenges. The opportunity to work collaboratively with elected members, NHS partners, voluntary sector, and — most importantly — local communities, is what makes the role both demanding and deeply rewarding. 

Workforce challenges

We cannot discuss the future of public health without acknowledging our workforce. Our teams are deeply committed, highly skilled — and exhausted.   

We need honest conversations about capacity, priorities, and sustainability. And yes – pay and respect within local government. The long‑term strength of public health depends on how well we nurture and retain talent, and we need to invest in professional development and public health training. 

A collective voice

We operate in distinct local contexts, but the challenges facing us are shared nationally. There is real strength in continuing to learn from one another — through regional networks, ADPH, and informal peer support. Hopefully the new Peer Review system will add and not detract from this. 

Membership of ADPH has been a vital source of support. It provides a collective voice for the profession, and a space for shared learning, honest discussion, and peer support. In a role that can feel isolated, experience, wisdom, and the encouragement of fellow DsPH cannot be overstated. 

No Director of Public Health has an easy life and it’s difficult sometimes to navigate local authority politics, NHS Bureaucracy, and ignorance about our profession. So, when I think, or indeed vocalise “Why, oh why, do I do this?”  – the answer must be that like all my public health colleagues; I want to do the right thing and make a difference to our communities. Optimism maybe, but I hope it is well placed.