"In an ideal setting, [the two programs] best perform when they're integrated together and are working together," said Linda Rosenstock, dean of the UCLA School of Public Health. "But the reality is that the healthcare side dominates the financial picture and dominates all the attention and all the visibility."
Dr. Thomas Garthwaite, director of the health services department since 2002, said the hospitals and public health programs recently have been trying to collaborate more, so he has mixed feelings about the proposal. He acknowledged that public health officials are fearful of wholesale cost-cutting in the department.
But "I think we cut them only modestly during my tenure here and tried to protect them," he said.
Public health staff have long complained about the difficulty of drawing attention -- and funding -- to their issues.
Between 2000 and 2002, for instance, public health had to return more than $10 million in state and federal grants because officials couldn't spend the money in time. They blamed rigid personnel policies that blocked or delayed hiring new workers.
If public health were its own department, it would have a direct line to the Board of Supervisors.
"I would have a better confidence in our ability to maximize health protection with all the new fears and all the new scourges, the bioterrorism and the emerging infections," said Dr. Jonathan Fielding, the current public health director.