The creation of the UK Public Health Alliance last week is to be welcomed by all those concerned to ensure that the issue does not slip unnoticed from the political agenda (see news focus, pages 12-13). Unfortunately, it may find that task harder than many would have anticipated two years ago.

For despite Frank Dobson's ebullience at last week's conference, the government appears to have lost its early passion and sense of urgency in tackling health inequalities. A couple of years on, for the health secretary still to be touting the appointment of the first public health minister as a great achievement is beginning to test people's patience. For that matter, just where is the minister and what is she doing? Tessa Jowell appears to have been effectively sidelined in a post without real levers of power, while political attention has focused on waiting lists and organisational upheaval within the NHS.

The one thing that might help create those levers, the public health white paper, is long overdue, and there is little sign of imminent publication. Meanwhile, Ms Jowell has found herself hosting an apparently endless succession of photo-opportunities for the local press. It is not quite the revolution we were led to expect.