Published: 02/12/2004, Volume II4, No. 5934 Page 22

Alex Scott-Samuel, joint chair, politics of health group

The public health white paper (news, pages 5-6, 18 November) carries the interesting subtitle 'making healthy choices easier'. This is appropriate for a report that in effect represents the government's discovery of health promotion.

Since the government wound up the Health Education Authority in its first term there has been no national lead on health promotion and a notable absence of support for such specialist staff in the NHS. Is this about to change?

Consistent with the government's market-driven agenda for the public sector, the white paper enthusiastically espouses health education and, more hesitantly, health promotion. The not so good news is that it is still focusing on diseases rather than causes.

Above all, if the government is serious about health promotion, it must establish a national body to provide leadership. The Department of Health cannot possibly provide a lead from within Whitehall; the Faculty of Public Health and the Health Development Agency - soon to be absorbed into NICE - lack the knowledge and skills to lead and support health promotion.

We knew enough to implement most of this white paper's proposals 15 years ago. It is time for prime minister Tony Blair and health secretary John Reid to make some real choices, to unashamedly espouse social values over those of the market, and to champion radical action for health.