15 minutes with . . .

The president of the Association of Directors of Public Health

Authors: Rubinder K Bains, Irfan Ghani, Mary Thompson 

Publication date:  06 Aug 2008

Can you give us a summary of your career, leading up to the present day?

I’ve always found epidemiology fascinating. Its basic appeal to me comes from an aptitude with numbers, which I inherited from my father, a maths teacher. I first became hooked while a medical student at Barts in the 1980s. We had an inspiring lecturer, Professor Nicholas Wald, now Sir Nicholas Wald. He invented the Triple Test, used to detect the risk of Down’s syndrome in pregnancy.[1] After I completed house jobs in 1989, I worked back at Barts as a senior house officer in epidemiology, which I loved. Coming from the hierarchical system in hospitals, I found myself able to touch the boundaries of human knowledge within a few months. I then did further senior house officer posts in oncology and gynaecology. In 1992 I joined the public health training scheme as a lecturer in public health at King’s College, London. After completing training, I worked as a consultant, becoming the director of public health at Croydon Primary Care Trust [PCT] in 2002. I joined the Association of Directors of Public Health [ADPH; [Link] ], becoming treasurer in 2004 and president in 2006.

What are the highlights of your career?

I coordinated the UK’s directors of public health into an effective parliamentary lobby before the 2007 ban on smoking in workplaces. As the single most important piece of legislation affecting public health in a generation, I feel proud to have played a small part in getting it through parliament. The next thing I’m proud to have done relates to my role as medical director in my PCT. I devised a tool called “practice profile.” This shows comparative levels of all sorts of things that general practitioners do. It was recognised as a good way to assess their performance by the Shipman Inquiry. More recently, I have edited the first revision book Mastering Public Health for the Faculty of Public Health Part A examination.[2] This book also provides a good practical guide and is a useful information tool for public health practitioners. I am also proud to have raised the profile of ADPH, perhaps to have given us a slightly louder voice than we have had before.

What are your plans for the future?

There is only so much one can do in a single PCT. Other problems are best dealt with at a national level. The biggest emerging problem for the UK today is obesity. We need to get more people walking and cycling. In my next role as the chief medical adviser for the Department of Transport, I will be pursuing these objectives.

You are the president of the Association of Directors of Public Health. What is the role of this association?

The association exists to promote the interests of directors of public health, especially to bodies that are able to influence public health policy. This would often involve talking to government, ministers, and opposition parties to help them formulate their approach to public health policy. We have recently released consensus statements with the Faculty of Public Health on alcohol misuse and also delivered consensus statements on “active transport.” The latter was achieved by coordinating more than 80 public health and transport organisations.

You are also the director of public health and medical director of Croydon PCT. How do you balance your work?

My hours are usually 9-5, but I’m quite happy to work whatever hours are required to get the job done. With many competing demands on my time, I also prioritise my diary ruthlessly. I could not function without such a strong and dedicated public health department behind me at Croydon PCT. I have been most fortunate to have had some really good colleagues there.

What qualities are needed to succeed in public health?

Having an “epidemiological approach” is an absolutely necessary quality. This is an ability to conceptualise the needs of populations rather than individuals. You must also be able to maintain an open mind, provide sound and credible scientific advice, and communicate this effectively to other people.

What advice would you give to juniors who are considering a career in public health?

For those of us who find change invigorating, particularly if you are the agent of this, then public health is a fascinating career. Like medicine itself, it is a broad church. Very few people in public health would expect to be doing the same job at 40 as they were at 30 or will be doing at 50. The career structure will allow you to move around, giving you diverse experiences.

Name: Tim Crayford

Position: Director of public health/medical director, Croydon Primary Care Trust; president, UK Association of Directors of Public Health

Biography: Medical student at Barts, London; senior house officer in epidemiology, oncology, gynaecology 1989-92; appointed director of public health at Croydon primary care trust in 2002

Competing interests: None declared.


  1. Wald N. The epidemiological approach: an introduction to epidemiology in medicine  . London: Royal Society of Medicine Press, 2004.
  2. Lewis G, Sheringham J, Kalim K, Crayford T. Mastering public health: a guide to examinations and revalidation (mastering)  . London: Royal Society of Medicine Press, 2008.

Rubinder K Bains public health doctor
Irfan Ghani public health doctor
Mary Thompson public health doctor Croydon Primary Care Trust


Cite this as BMJ Careers ; doi: