For someone who has worked at the "cutting edge" of environmental and public health, both on the policy frontline at the CIEH and at international level with the World Health Organisation (WHO), Ian MacArthur is ideally placed to comment on the profession's integral role in promoting health improvements.

Even back in 1991, when he was appointed assistant secretary for health and safety, Ian took a broad view of the profession's role. His ability to "see the bigger picture" was reflected in his concern over the dominance of food safety and the resources allocated to it, over other areas of environmental health. True, the number of people dying from accidents in the workplace each year might be roughly equal to food poisoning, but, as Ian points out now, "if someone contracts occupational cancer or loses a finger in an accident, then that is for life whereas with food poisoning most people do get better".

His interest in the wide context of public health, and its international dimension, paved the way for a secondment to the WHO in January 1993, where his remit included development work in Eastern Europe. With the scope for change developing rapidly, it was a challenging and exciting time to be working in the region. Ian has fond memories of the experience and is grateful for the opportunity he was given, working alongside international practitioners whose takes on environmental health differed from his own. "The experience opened my eyes to what we were all about and what we wanted to do," he says. While working at the WHO, Ian assisted in the creation of action plans which offered practical guidance to reforming countries on how best to cultivate health improvements. He admits that he found it hard returning to the CIEH after two years of such diverse experience. But he immediately channelled his energies into co-ordinating the Commission on Environmental Health, working alongside the likes of CIEH President Brian Hanna and Dr Tim Lang, professor of food policy at Thames Valley University. As the Tory administration began to wind down, he remembers casting a critical eye over the state of environmental health work in the UK, and came to the conclusion that "it was the right time to have a fundamental look at what we're all about".

The result was the Commission's report, Agendas for Change, which Ian describes as "another fantastic journey". Looking back, he feels privileged to have been involved in such an important project. "To put a room of such brainpower like that together and to say 'there's environmental health and what do you make of it?' was a unique experience".

The role of Council in supporting the project was he believes, pivotal, especially as the report captured the sea change in public health perception perfectly. Ian remembers that the last day the Commission met was the same day the Labour Party manifesto was published and many of the elements in the document mirrored those in Agendas for change. "I wouldn't have been surprised if there had been some cross-fertilisation between what our think-tanks on the Commission were doing and what fed into the Labour Party manifesto," he says. The timing was spot-on. The election of the Labour administration offered the CIEH a platform that had not existed for years, as at long last "we were singing from the same hymn sheet". Under the Tory government, he notes, people were not allowed to talk about health inequalities. But with the new administration "not only are people talking about it, but there are targets and budget reviews on how to tackle the problem." He believes that the period proved to be a watermark for the Chartered Institute - the annual conference in 1995 was one of the best in the charity's recent history and, he says, it really felt like "our time had finally come".

Ian notes with some irony that having waited so long for an administration that was receptive to public health issues, the charity was unable to keep up with the "cracking pace" of reform the new government had set. And while he agrees with most of the policies in principle, he points out that "as good intentions come to delivery, there are a number of issues we must challenge the current government".

While the current political climate bodes well for improvements in public health, Ian is conscious that the profession is more fragmented than ever. Some environmental health departments and individuals, he believes, have lost the linkage between environmental and public health, and the need to become more integrated is greater than ever. At the same time, he recognises that the fragmentation is partly a result of the different perceptions that Government, the profession and the public have of environmental health work. He identifies a dual role emerging: "One element that I would call public protection work and a potential element that I would call health development work".

Ian expresses his frustrations about the emphasis on the profession's public protection role. Food inspections, he argues, may have a health impact but it is now "as much to do with regulating economic market places than promoting health benefits". He cites the advances made in the food industry in reducing foodborne illness and the general consensus that most food poisoning takes place in the home as reasons for moving away from this role.

He also wonders why local authorities should be tasked with enforcing regulations that are dictated at a national level. "It is a bit disingenuous of our system to use local democratic bodies to deliver what are clearly national policies, particularly when local bodies have little or no say in the issue". Nevertheless, he accepts that from a public confidence angle, environmental health services will need to continue devoting resources to this type work. And while he recognises that the profession is unlikely to be relieved of its public protection role, he would rather see it make the most of its skills in health development - improving housing conditions and alleviating poverty and inequality; and working on the core determinants of health. The environmental health profession, he argues, is well equipped for such a role thanks to excellent communication and analytical skills, and broad approach to socio-economic and environmental issues.

He is optimistic about the future, but warns that the profession must be decisive and act now. The marketplace, he argues, will become "increasingly crowded with people who will try and develop themselves into a public health-type role" and he will be "really disappointed if the CIEH doesn't try and claim some of that ground". The profession's involvement, he adds, is critical to the emerging agenda, with its primary care trusts and emphasis on neighbourhood delivery of public health.

Within this new approach, he recognises the importance of gaining access to work with the private sector because "that's where a lot of decisions are made that influence the health determinants". There are opportunities to be had at the regional level as well, and he cites the emergence of regional public health directors as providing a unique opportunity for environmental health professionals to influence the debate.

Northern Ireland and Wales have set the precedent at the regional level and he is confident it will only be a matter of time before England follows. There will however, he argues, need to be some local structural reform if the Welsh success is to be repeated. "If we have large regional assemblies then local government probably needs to be a smaller, refined unit with different roles."

Ian recognises that there is good practice out there, and hopes that the new policy mechanisms of the CIEH can work to capture and develop it throughout the profession. He stresses that the profession remains a key player at all levels, even if environmental health work is not clearly defined by government. If it wasn't recognised, he argues "we wouldn't be benchmarked, put in league tables and told when we are not delivering".

The Chartered Institute's policy and development programme offers a unique opportunity for the profession to fulfil its potential in the emerging public health agenda. As a key player in the development of the programme, Ian insists that the CIEH has an important role to play in the debate and must emerge as the new advocates of public health.