Published: 10/04/2003, Volume II3, No. 5850 Page 22 23

The juxtaposition of your optimistic interview with public health minister Hazel Blears (the HSJ interview, pages 20-21, 13 March) with the pessimistic plight of local delivery plans ('Away with the fairies', news focus, pages 12-13, 13 March) sums up the experience of many public health specialists.

We have a supportive government, and we have never had it so good in terms of policy commitment to prevention and reduction of health inequalities.

There is an expectation not only that the Department of Health will prioritise reduction of health inequalities, but so too will other government departments.

Yet frequently reported experiences indicate that while meeting targets to reduce inequalities is desirable, it is likely to be sacrificed on the altar of aspiration as the system struggles to balance the books.

The short-term political imperative once again fails to take account of the good sense of upstream investment.

For example, helping people to give up cigarettes through smoking cessation programmes will, as Derek Wanless highlighted, reduce health burdens in the long term.

Professor Sian Griffiths President Faculty of public health medicine See feature, pages 28-31.