ABSTRACT
The institutional history of public health medicine in the UK has offered numerous threats and opportunities for effective practice. The task of using the new knowledge in shaping clinical discussion is centrally important for public health. Specifically, in the UK, moving the National Health Service (NHS) agenda away from ‘cure’ to an ‘effective cure’ and ‘efficient and appropriate care’ service is inextricably tied to the public health visions of Thomas McKeown and Archie Cochrane. Making a realist health strategy happen, however, is the major problem. Social justice, after all, is hardly a new concept and political parties have different viewpoints regarding what is just. If public health understanding and practice leaves things as they are it will have failed its purpose. At a minimum, the political conversation that society keeps going with itself must expand its horizons. Biomedicine has enabled politics to disengage with the human needs that will maintain and promote health.
