Hopes and expectations had been riding high that the proposals laid out in the white paper would make a real difference to people's health and wellbeing. But while many public health experts have welcomed the health secretary's commitment to improve public health, most agree that the recommendations fall short of what is really needed.

Certainly, there are plenty of things to be pleased about. To begin with, public health has been placed firmly at the centre of health policy, emphasising the need to promote preventative measures that improve health and relieve pressure from hospitals and doctors' surgeries. The government's commitment to attach health impact assessments to all future legislation could also lead to fundamental improvements in public health. And the white paper flags up a CIEH-supported healthy eating award, which will encourage healthier eating habits and help combat the UK's soaring obesity rates.

But at its heart, the white paper does come across as a compromise that may do little to reduce health inequalities. Dr John Reid should be commended for taking a bold step by introducing legislation that will ban smoking in all workplaces. But why wait until 2008 when we already know what the health risks are of breathing in second hand smoke? The proposal may even create a new kind of health inequality, allowing private membership clubs and pubs, bars and clubs that do not serve and prepare food on the premises to be exempted from the ban. So much for a level playing field. The proposals could also confuse businesses and prove difficult to enforce. Legislation has yet to be drafted, so EHPs should continue to campaign for a blanket ban that ensures all workers are protected.

The white paper's emphasis on voluntary rather than legislative measures for tackling obesity-related issues raises questions about the effectiveness of interventions. Little seems to have changed since the government's nutrition task force highlighted the negative influence of food advertising on children's diets nearly 10 years ago. Rather than act on this advice, the government has chosen instead to adopt voluntary restrictions on junk food adverts, although to its credit a time scale has been set for legislative action should these measures not work effectively. In the meantime, how many more children will become overweight or obese?

The proposed traffic light system for supermarket food, which provides consumers with information on foods that are healthy and those that should be eaten in moderation, is another welcomed move. But how effective will this really be when individual food producers are left to decide if they want to introduce the system or not.

Placing the white paper in context, we should, nevertheless, take heart. The publication of the Wanless report raised the public health profile immeasurably and it's true that we have come a long way in a remarkably short space of time. This government does seem genuinely intent on finding long-term solutions to the UK's health problems and we all need to continue to work to ensure that words are indeed put into action.

Looking ahead to the future, let me take this opportunity to wish you all a merry Christmas and a healthy 2005.

Nick Warburton
Acting editor