The government's much delayed public health white paper is now expected at the end of the month, despite continuing tensions between health officials and 10 Downing Street over some of its key proposals.

A Department of Health spokesperson denied that a date had been fixed or that there was any dissension over the details.

But HSJ sources said there were several areas in which Number 10 was anxious to head off adverse publicity. There had been considerable tension over proposals for health authorities to put more pressure on water companies to add fluoride to water supplies as a public health measure, sources said. Water companies are seeking exemption from their potential legal liability as a condition for doing so.

HSJ was told that there had also been a move to target alcohol as a major public health issue, in the same way as smoking has been tackled. But this is thought to be expensive, politically controversial and difficult to achieve.

Alcohol was included in the Conservative government's Health of the Nation proposals, but targets were not met.

But the present government appears to have accepted pressure from the age lobby to set health improvement targets up to the age of 75, instead of 65.

There may also be some movement on the issue of partnership with local government on public health.

The UK Public Health Association last week wrote to the DoH to argue that local government should be given a more prominent role in the white paper.

Early drafts gave the impression that local government simply 'tags along with the NHS', the association said.

The white paper is not expected to differ markedly from the green paper published in January last year, although some sources suggest that one of four priority areas may be dropped. The green paper proposed reducing accidents by one-fifth by the year 2010.

But that proposal may go because the NHS is not responsible for the prevention of accidents in the way that public health programmes can have an impact on the three other priority areas - reducing heart disease, cancer and poor mental health.

The issue of targets for reducing inequalities has not been resolved - no national target will be set in the white paper.