The public health system in England

The public health system in England

David J. Hunter
Linda Marks
Katherine E. Smith
Copyright Date: 2010
https://www.jstor.org/stable/j.ctt9qgt6f
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  • Book Info
    The public health system in England
    Book Description:

    Health systems everywhere are experiencing rapid change in response to new threats to health, including from lifestyle diseases, risks of pandemic flu, and the global effects of climate change but health inequalities continue to widen. Such developments have profound implications for the future direction of public health policy and practice. The public health system in England offers a wide-ranging, provocative and accessible assessment of challenges confronting a public health system, exploring how its parameters have shifted and what the origins of dilemmas in public health practice are. The book will therefore appeal to public health professionals and students of health policy, potentially engaging them in political and social advocacy.

    eISBN: 978-1-84742-464-8
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-ii)
  2. Table of Contents
    (pp. iii-iii)
  3. List of boxes and figures
    (pp. iv-iv)
  4. Acknowledgements
    (pp. v-v)
  5. List of acronyms
    (pp. vi-vii)
  6. About the authors
    (pp. viii-viii)
  7. ONE Introduction
    (pp. 1-16)

    Health systems everywhere are experiencing rapid change in response to new threats to health arising from lifestyle diseases, risks of pandemic flu, long-term conditions and the global effects of climate change and other threats to sustainable development. Issues that were previously viewed as distinct and separate are now regarded as inextricably linked through their impact on health with the result that a significant refocusing of policy is under way, albeit with varying degrees of success. Such developments have profound implications for future public health policy and practice. Public health, as a function embracing a wide range of skills and expertise,...

  8. TWO Public health and a public health system
    (pp. 17-48)

    As already noted in Chapter One, public health is a contested term, without a single or a simple definition. Its amoeba-like nature means its parameters change in line with perceptions of the key influences on the health and wellbeing of populations, while the components of a ‘public health system’ not only reflect how public health is defined but also inform the myriad of organisational routes through which public health problems are galvanised and addressed.

    In 1948, the World Health Organization (WHO) defined health as “a state of complete physical, mental and social well-being and not merely the absence of disease...

  9. THREE The evolution of the public health function in England (1): 1974–97
    (pp. 49-62)

    Previous chapters have indicated the potential breadth of a public health system. Chapters Three and Four are devoted to providing a historical account of the public health function in England. This chapter takes 1974 as its starting point, which is when lead responsibility for public health was transferred from local government to the NHS, where it has remained ever since. It covers the period between this significant change and 1997, when there was a change of government, which had significant implications for public health policy. The next chapter picks up the story from 1997 to 2009.

    The evolution of public...

  10. FOUR The evolution of the public health function in England (2): 1997–2009
    (pp. 63-102)

    The election of the New Labour government in 1997 represented an important shift for public health, or so it seemed, as the party had made bold and ambitious commitments to tackling health inequalities and addressing the wider determinants of health in its election manifesto. A series of documents and debates stressing the need to give higher priority to the health of the public, to end the fragmentation of the public health function and to start seriously developing and strengthening its multidisciplinary nature subsequently emerged (Department of Health, 1998a, 1998b; Secretary of State for Health, 1999). The decade or so since...

  11. FIVE Current issues in the public health system in England
    (pp. 103-148)

    The last two chapters described the changing public health landscape in England between 1974 and 1997 and post-1997 respectively, noting the key policy and other milestones in this journey as far as these have shaped and impacted on the direction of policy and the composition and configuration of the public health workforce. Such a period of intense activity, especially since 1997, has inevitably resulted in a range of issues and themes that remain alive and largely unresolved. They are explored further in this chapter and are all matters that are influencing an evolving public health system in one form or...

  12. SIX Looking to the future
    (pp. 149-160)

    If we are to meet the daunting health challenges already known to exist as well as those that will, in all probability, arise in future (but which cannot yet be discerned), then those responsible for the health of the public need to raise their game and their sights well above what Wanless et al (2007: xxvi) call “piecemeal, often modest initiatives”.

    What are the 21st-century health challenges confronting us? Collectively, as Marmot and Bell (2009), among others, have pointed out, we face several global problems in need of solutions. Two in particular stand out and most of the others are...

  13. APPENDIX: NHS reorganisation – 1975–2009
    (pp. 161-166)
  14. References
    (pp. 167-186)
  15. Index
    (pp. 187-192)
  16. Back Matter
    (pp. 193-193)