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The first Public Health Act was passed, providing for the establishment of a General Board of Health and of Local Boards of Health, and empowered the latter to appoint a medical officer of health.

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Professor David Armstrong gave evidence to the Inquiry that during the 70s, 80s and 90s the medical community thought that infectious diseases had been removed as a major threat.

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The director of the PHLS, Sir James Howie, was concerned that MOHs no longer had the skills, experience and training, or the time, for adequate infectious disease control.

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The chairman of the PHLS board observed that there were so few medical officers with experience of communicable disease control that active intervention by PHLS laboratories was playing an increasing part in the investigation and control of infectious disease.

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A report supplementary to that of the Public Health and Administration Expert Group expressed the conclusion that the opportunities to establish a regional network of epidemiologists to link the CDSC and proper officers in local authorities, and to complement and supplement the activities of the PHLS, were not grasped until the early 1990s.

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The DHSS issued transitional guidance outlining the new, joint working arrangements, roles, and responsibilities arising from the National Health Service Reorganisation Act 1973.

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The guidance also advised local authorities to appoint a doctor to be known as the medical officer of environmental health as "proper officer".

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The public health focus shifted from clinical epidemiology, communicable disease control and medical administration to broader societal health issues like lifestyle and education.

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The Health Protection Agency was established.

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The number of public health physician consultants dropped to 405.

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The number of public health consultants declined by 17% and the number of non-clinical public health specialists increased by 39%.

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The position of MOH employed within local authorities was abolished at a time when the government considered that the "main infectious diseases which were once the major cause of death of people of working age have been virtually eliminated as health problems".

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Professor Brian Edwards suggested that the loss of the MOH was a grave strategic error and the public health voice was weakened by that reorganisation.

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Health authorities were advised to appoint both a director of public health and a consultant for communicable disease control, while also reinforcing hospital roles in infection control and empowering proper officers to conduct investigations.

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The CDSC was established within the PHLS in 1977 after the 1973 smallpox outbreak in London and subsequent Committee of Inquiry into the outbreak.

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After the CDSC assumed responsibility for national advice, assistance and coordination in communicable disease control from the CMOs of the DHSS and Welsh Office, the epidemiological role of PHLS increased from one of epidemiological intelligence to a greater involvement in active disease control.

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PHLS received limited additional funding of £40,000 per year to cover the costs of its new functions.

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In 1984, the CDSC merged with the PHLS Epidemiological Research Laboratory, expanding its functions to include research on vaccine-preventable diseases.

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The ERL was created to undertake the analysis and interpretation of centrally collected laboratory data.

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The Public Service Laboratory Act of 1960 transferred responsibility for PHLS from the Medical Research Council to a new PHLS board that was accountable to the Minister of Health.

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