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Editorial

New government: new risks for public health?

In the UK, life is settling into a new normality following the General Election last month. Although there should be no surprises when the public is invited to exercise its democratic right to vote, it did prove interesting to see the main pre-election polls, which all predicted a hung parliament e one in which no single party has a majority e proved radically inaccurate. As a result of the election, the fiveyear coalition government, the first since immediately post-war Britain, came to an abrupt end. The UK now has an unfettered Conservative government: whether unfettered is a good thing, allowing government to introduce important policies that would otherwise have been diluted through compromise to reach agreement among coalition partners; or a bad thing, allowing government to introduce right wing policies uninfluenced by other views e is open to analysis and opinion, and will be subject to close monitoring. As far as health is concerned, the government has been presented with many ‘asks’ by the medical community,1 to which it has been asked to respond in its first 100 days, and of which it will no doubt continue to be reminded thereafter. These ‘asks’ include some of direct relevance to improving the health of the population:  Avoid another top-down, large-scale NHS structural reorganisation, whilst giving local areas the stability required to make progress on vital work to reshape care;  Prioritise reducing preventable illness and the maintenance of wellbeing;  Detail concrete plans to make mental health services as accessible as physical health services by the end of the next parliament; and  Commit to adequate funding for health and social care.2 On his reappointment as Health Secretary, Jeremy Hunt announced that ‘My biggest priority now is to transform care outside hospitals e just as we have dramatically improved the quality of care inside hospitals in the last few years.’3 Clearly, there is some way to go before the specific ‘asks’ are answered, but 100 days is a long time in politics and a very short time in public health. The devolved nature of government in the UK adds further complexity: it means that, on

many issues, we continue to have four, rather than one, national health policies, one for each UK nation. The priorities of the four countries are not identical, which is no surprise, but brings additional challenges to those outside government who hope to influence. UK practitioners of public health will have noted, mostly with some concern, that the new UK government has proposed repeal of the Human Rights Act (1998)4 and to replace it with a UK Bill of Rights or something similar. The precise impact of any legislative change will obviously depend on its detailed drafting. There have been different reactions to this proposal, but most have focussed on the potential harm to the wellbeing of those people most in need of sanctuary and protection, and on the potential damage to the reputation of the UK internationally if the current law is repealed. The note of caution from a peer seems to be very appropriate: the minister ‘would be well advised to consult widely on this difficult subject and then to publish a draft bill for prelegislative scrutiny.’5 Whatever is proposed will have to be compatible with the UK being a signatory of the International Convention on Human Rights, withdrawal from which does not appear to be under consideration. We await the draft proposal with some trepidation, but hopeful that good sense, social justice and morality will prevail. Looking beyond our shores, we are pleased to see that several UK universities are teaching global health at both undergraduate and postgraduate level and a paper in this issue of Public Health6 has looked into this. An understanding of health in a wider context has to be of value to health professionals wherever they are based. The USA and Canada have an established track record of offering such courses, as well as some other universities across Europe. The fact that demand for such courses is buoyant is testament to their relevance to a wide constituency of potential students, but access is currently inequitable, with medical graduates and undergraduates more likely to access global health courses than people from other disciplines. The concept of the development of a whole generation of global health practitioners from a wide range of professional disciplines is an attractive one, which may have capacity to influence global health policy and delivery of global health improvement, though open, as always, to serious evaluation.

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references

1. Academy of Medical Royal Colleges. What the medical profession is calling for from the next Government: a compendium of views of Medical Royal Colleges and Faculties. UK Academy of Medical Royal Colleges Manifesto. Available online at: http://www. aomrc.org.uk/dmdocuments/AoMRC_manifesto_2015.pdf; April 2015 (last accessed 01 June 15). 2. The Royal College of Anaesthetists. You can't always get what you want. The Royal College of Anaesthetists. Available online at: http://www.rcoa.ac.uk/news-and-bulletin/rcoa-news-andstatements/presidents-statement-from-the-forthcomingbulletin; 15th April 2015 (Last accessed 16 may 2015). 3. Department of Health. Health secretary Jeremy Hunt on his reappointment. London: Department of Health. Available online at: https://www.gov.uk/government/news/health-secretaryjeremy-hunt-on-his-reappointment; 12th May 2015 (Last accessed 16 may 2015). 4. Horne A and Maer L. From the human rights act to a bill of rights? Available online at: http://www.parliament.uk/ business/publications/research/key-issues-for-the-new-

parliament/security-and-liberty/from-the-human-rights-actto-a-bill-of-rights/(Last accessed 16 may 2015). 5. Lord Pannick QC. Should we repeal the human rights act? the times; 15th May 2015. 6. Harmer A, Lee K, Perry N. Global health education in the United Kingdom: a review of university undergraduate and postgraduate programmes and courses. Public Health 2015;129(5).

F. Sim P. Mackie The Royal Society for Public Health, John Snow House, 59 Mansell Street, London, E1 8AN, UK E-mail address: [email protected] (P. Mackie) Available online xxx http://dx.doi.org/10.1016/j.puhe.2015.05.017 0033-3506/© 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

In this issue This month's bumper issue covers a broad spectrum of public health research, practice and policy topics. From around the world, we are increasingly seeing high quality papers of relevance to other parts of the world, which makes for a rich reading experience, wherever you happen to be based. Papers from Canada and the UK address social capital. Universities feature in papers from the UK e on teaching Global Health at degree level; on blood born virus testing on campus; and on what students perceive constitutes a healthy university. On immunisation, we have two papers: on uptake and attitudes towards workplace immunisation and on monitoring adverse effects of immunisation in the French armed forces. Papers feature on management of TB and dengue fever, and impact of influenza H1N1 during the 2009 pandemic. We continue to publish episodes of the unfolding story of the Glasgow effect, which is becoming a real-life public health mystery to compete with many fictional sagas: this one should result in real lives being saved. There is much more in this issue: please read the full issue to appreciate it.

New government: new risks for public health?

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