Public health in the UK: success or failure?

Public health has come under criticism in recent times in some quarters, charged with failing to tackle important health problems over the last 30 years in the UK. This criticism has come most notably from Derek Wanless in his influential report, Securing Good Health for the Whole Population.1 He alleges for example that `the major drivers of public health have been recognized since the 1970s, with numerous “upstream” and “downstream” public health strategies having been proposed. However, 30 years on, despite some successes, implementation has been partial at best'. Other critics allege that `public health has made no significant contribution to policy since the Ottawa Charter' (personal communication, T Jewell). Currently, the re-organization of Primary Care Trusts and Strategic Health Authorities in England once again threatens to destabilize existing public health teams in England, only a few years after the upheavals of the implementation of `Shifting the Balance of Power' initiative. However, despite the organizational turmoil that has been facing public health in recent years, we would challenge the view that public health in the UK has not had considerable success to date. Evidence to support this view, and reasons for some of the failures will be discussed.