ABSTRACT
The issues at the heart of health promotion and illness prevention fall under three headings: administrative or logistical problems, socio-political factors and moral or ethical questions.
Administrative problems The distinction between health promotion and illness prevention, and the different approaches to each, are reflected in uncertainty as to which approach is likely to be most effective in any particular circumstances. For example, should women be exhorted to examine their own breasts, should GPs be encouraged to hold regular wellwoman clinics, or should there be a national breast screening programme? Whichever strategy is adopted (and in practice a mixture will usually be apparent), a large number of agencies and professional groups will need to be involved, making collaboration and teamwork more urgent than ever. This is an area in which the NHS has traditionally performed badly (O’Keefe et al. 1992; Ottewill and Wall 1990).
