Darzi bowls us a googly

Lord Darzi's final report is a welcome boost for quality of care but fails to address the quality of those key local NHS responsibilities that lie beyond healthcare settings.

Nowhere in its 92 pages did I see the words "public health" or "population". And nowhere does it address the issue of how the three domains of public health - health improvement, health protection and healthcare strategy - can be better joined up and tied into quality.

The report delivers the odd googly for public health. The proposed strategic medical directors could be treading on the toes of regional directors of public health and the new "quality observatories" might duplicate much of the work done by regional public health observatories. But no doubt these glitches can be ironed out.

All in all, there are opportunities for advancing public health in the report but I fear there are more opportunities missed and we will have to work hard to ensure health and healthcare are not swamped by the clinical imperative.

Dr Alan Maryon-Davis, president, Faculty of Public Health