Letters

I was glad to see Gerald Wistow's approach to the NHS plan as 'half full' rather than 'half empty' ('Exclusive offer?', page 27, 19 October). The UK Public Health Association has similarly welcomed the plan's commitment to developing targets for tackling inequality and to shifting resources to disadvantaged communities as part of the improvement of the public's health. These are indeed things to build on.

But he is also right to emphasise the importance of building in the contributions of local government (he could have added the voluntary sector) in promoting public health. Given its new health powers (and scrutiny roles), there is a need to ensure that partnership with health is top of the list of priorities rather than an add-on, only addressed when all the 'real' priorities have been sorted out.

Departmental objectives have to be secondary to joint endeavours; initiatives must be set in the framework of a shared plan; single issues must not overturn the importance of the collective response.

This is easy to say, and hard to achieve. With so many new schemes still coming down from on high - and coming down separate chimneys to local councils and health authorities, primary care groups and trusts, regeneration areas and action zones - it is hard to find the time to stand back and set them all in a context of health and well-being for the population.

The power to act has got to be just that - power - and not simply another responsibility without resources or respect.

The NHS plan - and its counterparts in community planning and neighbourhood renewal - has to recognise this and has to enable the action needed to take place in practice.

John Nicholson Chief executive UK Public Health Association Manchester