Editorials by Alderslade, Palmer Recent advances p 584 Education and debate pp 587, 592

I keep copies of all major acts of parliament relevant to health and health care. I have consulted them from time to time over the past seven years. However, it is the 1848 public health act (An Act for Promoting Public Health) that I have looked at most regularly. Why does this act fascinate me, and why did I wish to see further reflection on its background and consequences? The answers lie in an understanding of the context of the act and its consequences. This is not because of the act's specific contents—though the regulations on slaughterhouses and the selling of meat are fascinating—but because of the general issues the act raises:

• The principles of improving the public health

• The role of the state in improving the health of the people

• The organisation of public health at all levels in England and Wales

• The consequences of the act and the manner in which it raised the profile of public health

• The links to current issues in health and health cre.

The purpose of the act was to promote the public's health and to ensure “more effective provision … for improving sanitary conditions of towns and populace places in England and Wales.” Such clarity of purpose is impressive. The background to the act was a remarkable piece of work on mortality and morbidity rates across the country. The work established clear inequalities in health and recognised that some fundamental issues, such …