Intended for healthcare professionals

Education And Debate

Everywhere and nowhere—a Socratic dialogue on the new public health

BMJ 1999; 319 doi: (Published 25 September 1999) Cite this as: BMJ 1999;319:839
  1. Ian Wylie, director of corporate affairs (,
  2. Siân Griffiths, directorb,
  3. David J Hunter, professorc
  1. a King's Fund, London W1M 0AN
  2. b Department of Health Policy and Public Health, Oxfordshire Health Authority, Oxford OX3 7LG
  3. c Department of Health Policy and Management, Nuffield Institute for Health, University of Leeds, Leeds LS2 9PL
  1. Correspondence to: I Wylie
  • Accepted 26 July 1999

This is a dialogue between Hylas and Philonous, the design of which is plainly to demonstrate the reality and perfection of partnership working and the immediate providence of a minister for health in opposition to the sceptics and atheists among public health specialists. (With apologies to Bishop Berkeley, philosopher and author of Three Dialogues Between Hylas and Philonous, 1713.1)

Philonous: Well, Hylas, what cheer? Why so downhearted, when all seems to be going so well for you? Have you not yourself told me that there has never been a better time to be in your business?

Hylas: My business? What, pray, do you call my business?

Philonous: Why, the business of public health, of course! The health of every child, woman, and, yes, even every man, in the land. After years of toiling in the underworld, haven't you been telling everyone that you have climbed into the airy uplands and are basking in the sun of recognition. Why, lately our minister herself, at a confederation meeting, has called for public health to be at the centre of the health service.

Hylas: Well, yes, it is so. But I have this note from my editor who tells me that his readers find public health vague, unexciting stuff.

Philonous: How so? Why, last time we met you told me how even heart surgeons would soon be thinking about health. How these technicians would soon become health promoters, proselytising for the greater health of the public. Won't such thoughts excite passion in thinking, sentient beings?

Hylas: They say it's all too soft. These fellows would measure social benefit by ruler and divider. All they want are facts about savings, facts about costs, facts about waiting lists, facts about facts.

Philonous: Hum. Yes, I see …

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