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David J Hunter, Cambridge: Polity Press, £50, pp 224. ISBN 0-74-562646-7
“Advancing the public’s health has always been the stated goal of healthy policy, even if in practice a systematic bias in favour of responding to ill health and tackling disease has remained all pervasive and remarkably impervious to change”.
While this quote doesn’t appear until halfway through Public Health Policy, it is from this perspective that Hunter approaches his analysis. The text details the history of the public health sector in the United Kingdom as well as the problems and issues that have faced and will continue to face the policy makers who enjoy responsibility for the public’s health, from the House of Commons to the NHS. While historically confining his analysis to the UK, the well organised history of the struggles faced in the UK parallel those faced by developed and developing countries. The pitfalls of the competing priorities of the “downstream” focus on current health care offerings (treatment) compared with the “upstream” positive effects of shifting focus to a public health perspective (prevention) are analysed on many levels and from varying viewpoints. Hunter offers potential solutions to some of the difficulties that face decision makers struggling to formulate health policy that reflects a shift in priorities. The book is well written and offers insights useful for all who have an interest in improving the public’s health, whether in the UK or elsewhere.