Peter Littlejohns

A public health crisis is gripping the UK. Improvements in life expectancy have stalled, health inequalities have widened, obesity and alcohol misuse are placing an increasing strain on health services and urban air pollution is now widely recognised as a serious health hazard. COVID-19 revealed the weaknesses of the UK's public health system, once thought to be among the best in the world. Against this background, this book examines the organisational and political barriers to an effective public health system showcased through the UK. It urges that what is needed is a new social contract, in which health policy is truly public.

Sharing the costs of ill health is the mark of a civilised society. However, every society has limited healthcare resources, and must therefore make finely balanced decisions on how best to allocate them. The National Institute for Health and Clinical Excellence (NICE) has been responsible for the UK's health resource allocation for a decade. To inform its decisions, a Citizens Council of 30 members of the general public was established by NICE to gauge the underlying values of the society it serves. A number of national and international organisations and governments have asked NICE to share its experiences in establishing and running the Citizens Council, and encouraging and supporting patient involvement. As part of NICE's response, this book provides an up to date 'position statement' on the Citizens Council, an exploration of how patients interact with NICE and how their views are taken into account, and a national and international perspective on new issues facing the interaction between patients, the public and healthcare provision. 'Reading this volume will enable you, the reader, to assess how well NICE is acting as a means of fostering responsible public choice. I hope you profit from its chapters as much as I have.' - Albert Weale in his Foreword

The shift of services from acute hospitals to general practice requires clinicians to become actively involved in the process of change. This book sets out to demonstrate that with careful planning, implementation and evaluation of this process, problems can be avoided and the quality of service enhanced. The authors demonstrate a clear understanding of the practical issues involved and their evident enthusiasm for the opportunities now available will stimulate innovation in hospital staff, the health care team in general practice and NHS managers responsible for the delivery of a more efficient and responsible service.