In the first of a two-part series relating to the current status of environmental health education, Harold Harvey looks at the performance of environmental health as an academic subject in the UK and the steady decline in applications to CIEH accredited courses.

The initial entry to the environmental health profession in the UK is through an honours degree in environmental health, or a conversion masters degree. In previous years, entry to the profession was through a portfolio of subject specific certificates issued by the Public Health Inspectors Education Board (PHIEB) or a Diploma in Environmental Health from the Environmental Health Officers Education Board (EHOEB). Candidates studied for these most commonly on a part-time day release, or block release, basis at a technical college, college of technology or polytechnic. The transition to a degree entry profession began in 1964, with the introduction of an honours degree course at the University of Aston in Birmingham, and was completed with the phasing out of the EHOEB Diploma in 1996.

THE CHANGING FACE OF HIGHER EDUCATION
In 1985, the then Secretary of State for education, Keith Joseph, introduced ideas for a squeeze on "underperforming" higher education institutions, greater "selectivity and concentration on research" and a reduction on the reliance on the taxpayer.1 This was the starting point for major changes in higher education in the UK, all of which have had a significant impact on environmental health education. His successor, Kenneth Baker, drastically reduced student numbers in "underperforming" universities and the one-time flagship environmental health degree at Aston was closed as a result.

Through the Further and Higher Education Act 1992, Kenneth Clarke turned polytechnics (hosts to the majority of environmental health courses at that time) into universities, and introduced new arrangements for quality assurance. The results of these changes mean that today there are twice as many students in higher education than 20 years ago, the unit of funding per student is about 40 per cent less, student:staff ratios have changed from 8.5:1 to 20:1 and research, which was not a significant issue in polytechnics, has become the key performance measure of quality in universities.2 More recently, student grants have been replaced by loans and most students now contribute to tuition fees. During the same period, the number of students with financial sponsorship provided by their employers has substantially reduced.

Environmental health degree courses are not well placed to absorb these changes. They are comparatively expensive to run due to small class sizes, laboratory activities, field trips, placements and accreditation. The vocational orientation of the curriculum requires more staff:student contact - increasing staff costs and reducing the opportunities for academic staff participation in other key activities, such as research. Consequently, environmental health as a university subject is vulnerable and its future is not guaranteed.

STUDENT APPLICATIONS AND ENROLMENTS
There has been a significant, perhaps dramatic, decrease in the number of applications to CIEH accredited environmental health qualifying courses in the UK during the period 1996 to 2000 (table 1). In the academic year 1999/2000, only half as many applications were received as compared with 1996/1997. During the same period, the total number of applications to all UK university undergraduate courses remained about the same and the number of applicants increased by nearly six per cent.3

For example, in one university which received a total of 32,125 applications for all courses for 1999/2000 entry, only 98 applied to environmental health. The UCAS system, through which applications are made, allows students to apply to up to six different courses at UK higher education institutions. As candidates may later decide to confirm their application to any one of the other five courses, only a small percentage of all applications to environmental health translate into serious applicants. Of these, several will not meet the minimum entry requirements and will be excluded. Therefore, 100 applications may provide as few as 10 or 12 new additions to environmental health student numbers.

The reduction in applications is clear, but the reasons for the decline are not so obvious. The following factors emerge as likely to be significant:

• the changes in the financial arrangements which have replaced student grants with loans and the introduction of student or parental contributions to course fees has made four-year courses less attractive;
• the reduced number of local authority sponsorships;
• the limitation placed on potential applicants by the need to find a training placement as part of the application process; l the move from paid to unpaid placements;
• the misleading portrayal of the work of EHOs in the media;
• insufficient promotion of the profession;
• insufficient course promotion;
• less public clarity regarding the role of the EHO due to the increasing use of other titles such as food safety officer, health and safety inspector, and noise inspector;
• the current uncertainties surrounding secure employment in local government and the perception that environmental health graduates are restricted to work in local government only;
• the reduced value which society places on public service roles;
• comparatively unattractive salaries following completion of a four-year course and professional assessments;
• reduced opportunities for career progression, due to environmental health departments being subsumed within combined local government departments;
• the percieved additional hurdle of the logbook, professional examinations and professional interviews;
• perceptions of the nationally reported outcomes of the "research assessment exercises", where a high research rating may be seen as a reflection of quality in the eyes of pupils and those advising them;
• reduced entry requirements to other courses previously beyond the reach of some applicants to environmental health;
• increased competition from other "health" and "environment" related courses; and
• the perception that the EHO is not a true professional, a view supported by the International Standard Classification of Occupations, where health and environmental officers are considered "associate professionals".4

The reduction in applications and enrolments will have several effects. At a time when additional EHOs are needed to meet the enhanced objectives in food safety and health and safety, reduced output from environmental health courses may lead to a recruitment crisis for local government, which may already have started.6 This may, in turn, bring about an increased dependence on non-CIEH registered staff to carry out the work of environmental health departments. In the higher education situation, the impact of reduced applications and enrolments may be even more important for the future of the environmental health profession in the UK.

Environmental health courses are already at the lower end of viability, due to the high running costs of four-year accredited courses and enrolments limited by the availability of professional training placements. In the current recruitment regulations, each university has what is referred to as "maximum aggregate student number". This is a target student enrolment figure set by the Government and there are financial penalties if the figure is not achieved, or if it is exceeded. Thus, where the total enrolment figure is capped there is little incentive for universities to retain courses with low student numbers.

Environmental health academics and others have had to argue the case for the retention of environmental health courses in some universities. As the number of applications decline, with the concomitant reduction in quantity and quality of enrolments, this argument becomes increasingly difficult to sustain. Two environmental health courses have closed in the past year and others are at risk.

SUBJECT REVIEW OF LEARNING AND TEACHING
The documented purpose of "subject review" (now academic review) is "to ensure that the public funding provided is supporting education of an acceptable quality".6 The review is carried out by the Quality Assurance Agency for Higher Education (QAA) on behalf of the funding councils. The QAA's mission is to promote public confidence that the quality of provision and standard of awards in higher education are being safeguarded and enhanced. It does this by auditing the arrangements for managing quality in each university and by detailed assessment of the quality and standard of teaching and learning in each subject. For the purposes of the review, academic subjects are grouped into units of assessment (UoA). Environmental health is not a recognised UoA subject and has been placed within a diversity of UoA including, building, civil engineering, subjects allied to medicine and earth, environmental sciences and environmental studies.

In vocationally oriented subjects where professional body accreditation is significant, there is provision for joint reviews to be carried out by the QAA and the professional bodies. This is encouraged by the QAA as a means of integrating the academic and professional aspects of learning and teaching provision in higher education. It is also of benefit to the course providers in that it reduces the possibilities for conflict between the requirements of the QAA, acting on behalf of the government paymasters, and the professional bodies seeking to uphold the requirements for entry to the profession. Environmental health courses to date have been separately assessed by the QAA and by the CIEH.

At present, there is no direct link between the outcomes of a subject review and funding for courses. The teaching element of a university's income is based mainly on student enrolments. The extent to which the outcome of the subject review influences applications and enrolments to individual subjects or universities is unknown. In today's informed consumer society however, a good score is likely to provide a marketing advantage.

WAY FORWARD
Significant progress has been made in environmental health education in the past 20 years through the contribution of environmental health academics, local authorities and a supporting partnership with the CIEH, and this progress has brought salient benefits to the profession. However, environmental health is a minor player in universities, does not measure up well to the current university key performance measures and has a vulnerable future in the competitive higher education environment.

If environmental health courses are to survive and develop in UK universities, scholarly activity in both teaching and research is necessary. The balance will need to shift towards research, with more staff becoming research active and more students completing research degrees. An alternative would be for CIEH accredited courses to be developed as sub-degree courses in the further education environment, although this would have implications both for the classification of environmental health as a profession and career progression.

Short and longer-term measures to increase applications are essential to the survival of CIEH accredited courses. Such measures could include:

• improving the image and public perception of EHOs;
• increasing the number of quality placements;
• including environmental health issues and the contribution of EHOs within pre-university education;
• reduction or removal of any additional financial burdens on students of environmental health;
• the introduction of an environmental health student scholarship scheme; and
• re-enforcing the title EHO, or any future alternatives.

Action aimed at raising the profile of environmental health as an academic subject and support for academic activity is necessary for the long-term survival and development of the subject at this level. This could include:

• the encouragement of CIEH nominees to seek membership of university councils, senates and other university public committees;
• setting up a prestigious, regular "environmental health lecture series" in universities;
• the introduction of environmental health research studentships;
• the continuation of support for the annual graduate/post graduate research conference on environmental health protection and safety and the development of other such events;
• measures to integrate the academic and professional elements of CIEH accredited courses, including a review of the current CIEH accreditation process; and
• measures to foster closer links between the universities and the CIEH regional centres.

This said, there are a number of measures already in progress with the longer-term aim of ensuring the survival of CIEH accredited courses and raising the profile of environmental health as an academic subject:

• action is being taken by the CIEH to increase the awareness of careers teachers about environmental health;
• the sandwich format of CIEH accredited courses is being reappraised, with a view to reducing the time in a higher education institution to three years full time;
• entry requirements to environmental health courses are being reviewed, with a view to widening the applicant base;
• lobbying for the development of a national strategy for the education and training of EHOs;7
• the opening up of dialogue between the CIEH and the QAA, the committee of vice chancellors and principals (now Universities UK) and the individual university vice chancellors;
• the CIEH is currently planning to publish a national peer reviewed journal on environmental health research, with the first issue set for publication early next year; and
• the CIEH committee agendas are being expanded to include the wider requirements of the advancement of environmental health as an academic subject in universities.

REFERENCES
1 Department of Education and Science (1985) "The development of higher education into the 1990s". London, HMSO.
2 Watson, D, Bowden, R (1999) "Why did they do it?: The Conservatives and mass higher education, 1979-97". Journal of Educational Policy, Vol.14, No.3,243-256.
3 UCAS (2000) Summary statistics 1994 - 1999. Web: http:// ucas.ac.uk/figures/archive/summary/main.html [accessed 01 March 2001].
4 International Labour Office (1990) ISCO-88: International Standard Classification of Occupations. Geneva.
5 Bushell, F (2000) "Crisis as students desert local government". Environmental Health News, Vol 15-2, 14 January 2000, page 5.
6 QAA (1999) Code of Best Practice - Board of the Quality Assurance Agency. Web: http://qaa.ac.uk/aboutqaa/qaaboard/qaaboard.htm. [accessed 01 March 2001].
7 Parkinson, N (2001) "A national strategy for environmental health education". Environmental Health News, Vol 16-5, 16 February 2001, page 5.

Harold D Harvey is Director of the Environmental Health Protection and Safety Centre, University of Ulster, Northern Ireland, BT37 0QB, UK. Tel: 028 9036 6309 Fax: 028 9036 6840 or e-mail: hd.harvey@ulst.ac.uk

Next month: Harold Harvey argues that a lack of research activity in the field of environmental health could prove fatal, not just for universities, but for the profession as a whole.