Views & Reviews

What the white paper might mean for public health

BMJ 2010; 341 doi: (Published 23 November 2010) Cite this as: BMJ 2010;341:c6623
  1. Anthony Kessel, honorary professor, London School of Hygiene and Tropical Medicine,
  2. Andy Haines, professor of public health and primary care, London School of Hygiene and Tropical Medicine
  1. Correspondence to: A Kessel anthony.kessel{at}

This coming winter, in the wake of the newly laid out plans for the NHS, the UK government will publish a white paper on public health.1 2 We are promised a new Public Health Service for England, and there is a real sense of anticipation in the public health world—though tempered by anxiety about upcoming public sector changes, suggestions of an influential role for the private sector in shaping public health policy, and the current economic climate.3 4 So, what might the new service look like?

For some years local public health teams have been based in primary care trusts. It seems that these teams will move into local authorities, although at what tier remains to be decided. Director of public health posts have already been moving in this direction through joint appointments with local authorities, although their teams have not necessarily followed. Aligning the directors with their departments would therefore seem sensible. This also provides a chance to even out some of the inequities in public health skills and resources that have developed between localities.

A further advantage of placing public health directors and their teams in the council architecture is the closer relationship with those involved in the distal determinants of health—for example, environmental health, housing, …

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