A senior UK public health official who has more than a decade of experience has said she is unable to continue her career in Ireland due to rules governing the specialty in the State.
Lisa McNally originally trained as a psychologist but quickly found a love for public health and transitioned to the field 13 years ago.
She is currently director of public health at Worcestershire County Council in England and is responsible for the health of more than 600,000 people.
From an Irish family, Prof McNally, who has won a number of awards for her work, said she wants to move to Ireland as it “sort of feels like home for us”.
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In Ireland, however, a primary medical degree and postgraduate training are required to work as a consultant or director in public health, meaning she would be unable to remain at her current level of seniority.
“I’ve got 15 or 17 years left in my career and would love to do that in Ireland. But I quickly realised there’s no chance. You can work in public health as a non-medic but only up to a certain grade. You cannot work as a consultant or director of public health,” she said.
“So basically if I moved to Ireland and got a public health job, salary-wise – which isn’t important to me – I would have to drop down four or five grades. I’d be managed by people who I actually manage their manager’s manager. It’s a real shame.”
She added that the role in the UK is a “statutory officer”, accountable to the secretary of state for health and social care.
“To be a consultant or director of public health, you have to be listed on the UK public health specialist registrar, the regulatory authority. You basically have to achieve competencies,” she said.
“We are all fellows of the faculty of public health. We have to go through yearly appraisals to ensure we’re still competent and we have to revalidate. We’re constantly checked upon and quite rightly.”
Prof McNally said the role involves health protection and prevention, such as healthy food, smoking cessation, substance misuse and mental health.
“You wouldn’t want us operating on your spleen – we’re not clinical, medical people. Many directors of public health are trained in other health-related fields and that makes a very rich workforce.”
Prof McNally said the country has a “missed opportunity” in not allowing people with non-medical backgrounds to pursue career progression in public health.
According to a 2023 Crowe report, commissioned by the Institute of Public Health, “highly qualified and skilled people with backgrounds other than medicine” have moved from Ireland to the UK to pursue careers in public health for “career pathways that would not be open to them if they had remained in Ireland”.
Asked if the HSE had any intention of changing the requirement of medical expertise, a spokesman said a director of public health in the HSE is required to, among other things, have completed Higher Specialist Training in the specialty (or equivalent) and be registered, or eligible to be registered with the medical council.
