Out with the bold, in with the new

Alan Milburn was possibly the most energetic health secretary there has ever been. But he focused too much on the NHS because of the shorttermism of the political cycle.

He was concerned about the causes of poor health, but couldn't rise above what appeared, to outsiders, to be a commitment to permanent revolution in NHS management.

Hopefully, Mr Milburn will become a wiser (if sadder) man, with a more philosophical view of the nature and role of the NHS, and a more aggressive view on what requires people to use it.

We have written to Mr Milburn's successor, John Reid, and asked him to take a longterm view. He needs to look at investment in public health and pay close attention to the work that Derek Wanless has done for the Treasury on the 'fully engaged scenario' in his report.

The biggest efficiencies are to be found in stopping patients being ill in the first place. The big disease time bomb for the future is chronic diseases - much of it entirely preventable.

Mr Reid should take the advice of public health minister Hazel Blears and make prevention the 'big issue' for his period in the hot seat.

Geof Rayner Chair UK Public Health Association