EHJ June 2002, pages 184-185 Earlier this year, Nigel McMahon took up the post as chief environmental health officer in the Department of Health, Social Services and Public Safety in Northern Ireland. He talks to Nick Warburton about the exciting opportunities for the profession to work in partnership in improving public health in the province

For many in the profession observing the public health agenda in England and Wales, there is a real possibility that developments in Northern Ireland may go unnoticed. Not only does this fail to do justice to the work of environmental health practitioners across the Irish Sea, but also ignores the fact that opportunities for Irish EHOs to tackle health inequalities have arguably never been so great.

The appointment of Nigel McMahon as chief environmental health officer in March 2002, represents a significant development for the profession in Northern Ireland. Nigel's wealth of experience across a broad range of environmental health disciplines and his close working relationship with ministers at the Department of Health, Social Services and Public Safety (DHSSPS) bodes well for the profession's participation in tackling health inequalities.

Born and bred in Birmingham, Nigel "returned with his family to his roots" in Armagh after sitting his O-levels in 1980. A natural aptitude for science-based subjects, combined with an interest in working with people led him to pursue a career in environmental health, and while studying at the University of Ulster at Jordanstown, he gained valuable experience during his student placement with the Southern Group Public Health Committee.

Graduating with a first class honours degree in 1986, Nigel joined the environmental health team at Belfast City Council. As he recalls, it was a difficult time to be starting out. "Many of the district councils were not conducting business as part of the 'Ulster Says No' campaign against the Anglo-Irish agreement," he says. "No meetings meant no approval of staff appointments". This meant that initially, Nigel worked as a meat inspector in the Belfast Meat Plant, an appointment which the then director of environmental health, Brian Hanna, had delegated responsibility for. It proved to be the beginning of a fruitful relationship with the CIEH president and one that has important implications for raising the profile of the profession in Northern Ireland.
Nigel subsequently moved on to join the housing and public health section in the council, where he took a particular interest in Houses in Multiple Occupation and leisure pool management. His duties took him to West Belfast, one of the poorest areas of the city. "At the time, it was considered to be a bit of a prison sentence... the combination of West Belfast and housing was the Alcatraz of the environmental health department," he says.

Despite the harsh realities of working in such a deprived area, Nigel looks back on the period with fondness, noting that the experience and the challenges it presented him, provided the basic start he needed. Earlier this year, a district of West Belfast where Nigel had worked, and which has since undergone significant redevelopment, was deliberately chosen as the backdrop to launch the Minister for Health, Social Services and Public Safety's Investing for health strategy.

From dealing with some of the province's worst housing, Nigel moved on to tackle arguably some of the UK's worst air pollution. Thanks to the lack of natural gas and the reliance on solid fuels, Northern Ireland has, as he points out, "tended to have episodes of sulphur dioxide and particles, which show figures higher than anything else recorded in the UK".

In 1993, Nigel joined the environmental health unit of the then environment service at the Department of the Environment for Northern Ireland. During his time at the department, he took the lead on a range of policy areas including ambient air quality, noise control, information technology and the emerging field of environmental impact assessment (EIA). Aside from his busy schedule, he also found time to represent the department on a number of expert groups and committees, including the Airborne Particles Expert Group (APEG), the Expert Panel on Air Quality Standards (EPAQS) and the Ministerial Group on Public Health.
Not content to sit back, Nigel gained an MSc with distinction in Environmental Impact Assessment from the University of Wales in 1996. Later that year, he took up a new post as the head of the air and environmental quality unit at the Environment and Heritage Service, an agency within the Department of the Environment. The position and the responsibilities that came with it presented Nigel with experience on a wide range of environmental issues, which have proved invaluable for his new post. "The air and environmental quality unit is a policy advice and development group which focuses on air quality and noise control policy," he says. "Its main aim is to ensure compliance with domestic and international standards, statutes and agreements relating to general air quality and noise control matters".

In recent years, a significant amount of his time at the department was taken up working in partnership with district councils on a voluntary system of local air quality management, set up in advance of the introduction of local legislation equivalent to Part IV Environment Act 1995. "At the moment everything is being managed on a good will basis," he notes. "We have taken our lead from the national guidance, but there is as yet no statutory backing or driver. We have come a long way together in this area and I am particularly proud of what has been achieved."

Securing the introduction of relevant legislation will be one of the key objectives of his new role as chief EHO, but there are many other areas, in which he intends to play a major part. "The main aim of this role is the provision of environmental health advice to inform and develop government policy," he says. "But it will also be important that I use the role and the access I have to what's going on in central government to communicate that back to the profession so that they can better appreciate the bigger picture."

Implementing legislation in fact will prove to be one of Nigel's biggest challenges. "Promoting consistent and effective implementation of relevant legislation by the 26 district councils and other agencies is essential," he adds. There is also, as he points out, already a significant backlog of legislation right across the range of environmental health sectors, largely due to political factors beyond the province's control. "As Northern Ireland legislation was formerly introduced by the order in council process through Westminster, this has meant that historically, legislation has not been issued for at least 18 months to two years after it has on the mainland," he says. The situation has not been helped by the lack of resources, which has added to the delay in introducing new legislation. "We have been battling infraction proceedings from the EU on non implementation on a range of directives," he adds. "There is a big catch up job and one of the first things that needs to be done is for the province to come into line with the rest of the UK".

In doing so, Nigel would like to see EHOs take on the health and wellbeing powers that exist in England and Wales. "We don't have them at all or any equivalent," he says "and this could be a potential problem, particularly if the message we are trying to spread through Investing for health is that councils should be doing more. If they don't have a statutory power or duty that they can rely on to build this type of health and wellbeing into their work, they may not exploit the opportunity that exists".

Despite the challenges these issues present, Nigel has good reason to be optimistic about environmental health developments in Northern Ireland. "The Investing for health strategy is a good start as it marks a shift away from the focus on the treatment of illness and medical care to the determinants of health," he says. Although it is still early days, he believes that there is an "open door" for environmental health in the Northern Ireland Executive, not just in terms of what environmental health can bring to policy development, but also from what he can bring to the post. The various government departments "may have been lacking advice in key areas because the post has been vacant for sometime and the emphasis prior to the establishment of the Food Standards Agency was necessarily on food issues," he notes.

Nigel also recognises "a number of elements" that are coming together "rather like a Rolf Harris painting", which bode well for environmental health to influence policy. He cites the appointment of Gary McFarlane as director for CIEH, Northern Ireland, Brian Hanna's position as CIEH president and overtures towards reorganisation at local government level as positive developments that should raise the profile of the profession in the province.

While Investing for health marks a positive shift toward the prevention of ill health, its success will depend largely on the effectiveness of partnerships at all levels of government and the voluntary sector. Bairbre de Brœn, Minister for Health, Social Services and Public Safety, acknowledged the ability of EHOs to play a key partnership role at the joint CIEH and Environmental Health Officers Association (EHOA) conference earlier this year. It is now up to the profession to show what it can bring to the table. And with Nigel's seat already at that table, environmental health is well placed to make a significant and valued contribution to the debate.