1997 Chadwick Lecture--is a healthy north west region achievable in the 21st century.

Edwin Chadwick, the very name evokes powerful images of Britain at its most self con fident and expansive. Victoria on the throne and the map of the world seemingly coloured pink. No challenge seemed too great for those mainly men who sought to conquer?other Peoples and Nations, the wilderness and the oceans and nature itself. Chadwick was truly a man of his times and a reflection of this unbounded self confidence, whose curiosity took him into a wide range of fields (fig 1). In his time his preoccupations ranged from working conditions (he was Chief Central Commissioner to the Factory Act in 1833), The Poor Law Report of 1832, which he in part wrote and the subsequent Poor Law Amend ment Act and Commission to which he was Secretary (fig 2). His Report on the Sanitary Conditions of the Labouring Population, for which he is perhaps