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Health InequalitiesCritical Perspectives$
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Katherine E. Smith, Clare Bambra, and Sarah E. Hill

Print publication date: 2015

Print ISBN-13: 9780198703358

Published to Oxford Scholarship Online: January 2016

DOI: 10.1093/acprof:oso/9780198703358.001.0001

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Health inequalities in England’s changing public health system

Health inequalities in England’s changing public health system

(p.138) Chapter 10 Health inequalities in England’s changing public health system
Health Inequalities

David J. Hunter

Linda Marks

Oxford University Press

This chapter assesses the relationship between different ways of understanding a ‘public health system’ and action on health inequalities. After briefly reviewing the historical evolution of the UK’s public health system, the chapter considers the growing diversity in the context of political devolution. It then provides an overview of public health reforms arising from the 2012 Health and Social Care Act in England, where a new national body, Public Health England, has been created and responsibilities at the local level have been transferred from NHS bodies to local government. The authors highlight some of the opportunities created by these recent changes, whilst also cautioning that, despite the reforms being widely welcomed by local authorities, the new public health system continues to face significant risks. These include a pessimistic public spending outlook and a policy context in which choice, markets, and privatization continue to be heavily promoted.

Keywords:   public health system, health inequalities, devolution, health reforms, Health and Social Care Act, UK, England, Public Health England, policy, privatization, choice, local government, NHS

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