In 1998, devolved government was returned to Northern Ireland following the Good Friday Agreement and the executive of the devolved administration (which is currently in suspension) produced its vision for a cohesive, inclusive and just society in the "programme for government". This has five overarching priorities - one of which is "working for a healthier people". Given the high level of poor health suffered by many of the province's populace, particularly those from the lower socio-economic sectors of society, this was a welcome and crucial aspect of the programme.

This priority committed the Northern Ireland Government to working to improve the health of all the people of Northern Ireland and to reducing health inequalities. As already discussed, in March 2002, the executive launched its health strategy - Investing for health - central to which is the commitment to ensuring equality of opportunity and tackling social disadvantage, recognising that it is through improving the living and working conditions of the most disadvantaged in society that great improvements in health can be made. The strategy is also consistent with the Government's commitment to its new "targeting of social need and equality" agendas.

There is much that should enthuse and motivate environmental health practitioners in all of this. Investing for health sets out a strategy which is as much about disease prevention and health promotion as it is about the provision of adequate clinical services. It carries within it a strong message about the social and economic factors which impact upon the health of the people of Northern Ireland.

This fits well with the enhanced role for EHPs in public health as set out in the vision statement Environmental health 2012.

A decision to review the public health function in Northern Ireland arose out of the Investing for health strategy process. A steering group chaired by the chief medical officer for Northern Ireland, Dr Henrietta Campbell, has been set up to carry out this work and is comprised of the following people:

• Dr H E Campbell, chief medical officer, DHSSPS (chair);
• Mrs Mary Black, project manager, North and West Belfast Health Action Zone;
• Mr Michael Bloomfield, principal officer, investing for health team, DHSSPS;
• Dr J A Muir Gray, programmes director of the National Screening Committee, Institute of Health Sciences;
• Professor Sian Griffiths, president of the Faculty of Public Health Medicine;
• Mr Brian Hanna, president of the Chartered Institute of Environmental Health;
• Miss Judith Hill, chief nursing officer, DHSSPS;
• Mrs Deirdre Kenny, director of health development, DHSSPS;
• Dr Paula Kilbane, chief executive, Eastern Health and Social Services Board; * Dr Liz Mitchell, principal medical officer, DHSSPS;
• Dr Mary O'Mahoney, head of communicable diseases branch, Department of Health, London;
• Professor John Watson, director of public health, Northern Health and Social Services Board; and
• Dr Jane Wilde, director, Institute of Public Health in Ireland.

The terms of reference of the review, due to be completed by February 2004, are as follows:

• to assess the current state of the public health function in Northern Ireland;
• to examine current arrangements and activities in relation to the ability to deliver current and likely future objectives for public health in Northern Ireland;
• to examine the relationship between health in Northern Ireland and the rest of the UK and Ireland and beyond in relation to organisation and development;
• to establish an agreed vision of the role of the public health function in Northern Ireland; and
• to make recommendations to strengthen the future provision of the public health function in Northern Ireland.
• Consultants have been appointed to support the steering group (Capita Business Services Ltd) and its working methodology and timetable has been agreed. The work, which began at the first meeting of the steering group on 19 June 2003, will take about nine months to complete. It has been agreed that the project be divided into two main phases of work:
• establishing the current status of the public health function; and
• developing a blueprint for the future public health function.

According to Dr Campbell, "the desire to improve public health was the primary driving force for many of the early environmental improvements in our society. In recent times, however, the subjects have tended to drift apart, both conceptually and in our institutions. The review is an opportunity for the environmental health service to consider its place in improving and protecting public health in the future."

A key part of phase one will be a document review, and both Agendas for change and Environmental health 2012 have been submitted to the consultants for inclusion in this review. There will also be key policy/strategy scene setting meetings and EHPs will be directly involved in the discussions through the CIEH director in Northern Ireland, Gary McFarlane, the Northern Ireland Centre of CIEH and the Northern Ireland Chief Environmental Health Officers Group. Local government in Northern Ireland will also be involved in the discussions.

The first meeting of the steering group was extremely positive and one important idea to emerge, and which will be explored further, is the possible creation of a multi-disciplinary young professionals group that could act as a sounding board for emerging ideas and suggestions. Such a group would contain a number of young EHPs. The steering group considered it important that the views and ideas of young professionals from across the various public health disciplines should feature strongly in the review process.

Running parallel with the Northern Ireland public health review is another important review - the review of public administration. This was begun by the devolved government and is well advanced, although no public report has yet emerged from it. The CIEH (NI) has made a submission to the review team and Gary McFarlane has been actively involved in promoting and pursuing the profession's interests in relation to it. The outcome of this major review of the province's public administration arrangements will have an impact on local government and the role and place of EHPs within it. It will therefore need to connect with the review of public health.

This point was raised at the inaugural meeting of the public health steering group and it was agreed that close liaison be maintained with those charged with carrying out the review of public administration.

Both of these important reviews will, of course, need to be considered by whatever political regime is charged with governing Northern Ireland. Will it fall to direct rule ministers, or local ministers in a restored Northern Ireland Executive, accountable to the people of Northern Ireland through a directly elected Assembly, to decide the future arrangements for both public administration and public health? Let us hope that it is the latter.

Either way, EHPs should approach the review of public health in a positive frame of mind and bear in mind that they are faced with an opportunity and not a threat. The review has the potential to produce an outcome which will enable EHPs to play a full and active role, in partnership with others, in the promotion and enhancement of public health in Northern Ireland. That is surely something that all EHPs should welcome.

Brian Hanna is president of the CIEH