Making Health Public: A Manifesto for a New Social Contract
Making Health Public: A Manifesto for a New Social Contract
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Abstract
There is a crisis of health in the UK undermining the health of the population. Despite the effectiveness of public health measures, UK governments have been reluctant to implement them. This book dissects this lack of action. It locates the implementation deficit in part in the intrinsic policy problems of attacking the social determinants of health, but crucially notes how governments have been trapped in an ideology of non-intervention.The book sets out the history of public health policy in England between 2013 and 2020, before looking at the growth of public health organisations in the other home nations. It argues that there is no one right organisational form for public health and that governments should focus not on organisational restructuring but effective policies and capacity.The challenges facing policy makers in the new settlement for public health that has emerged since 2020 includes issues like scientific integrity and political independence. What is needed is implementation of measures that have been advocated over decades, including most recently in the Hewitt Review of the new system of NHS governance in England.Public health measures have been held back by the dominance of a libertarian public philosophy that is sceptical of the ‘nanny state’. In place of this libertarian philosophy, the book sets out the terms of a new social contract underpinning the active government that is required if public health is to be advanced.
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