Article Text

Download PDFPDF
Take it with a pillar of salt or “ambitious but achievable targets”
  1. Division of Child Health, School of Human Development
  2. Floor E, East Block, Queens Medical Centre
  3. Nottingham NG7 2UH, UK
  4. email:

    Statistics from

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    The document Modernising health and social services—priority guidance outlines the policy for health and social services to 2002.1 It is divided into four sections entitled “Where are we heading?”, “How we get there”, “What needs to be done”, and “How will it work?” It is hard to disagree with a wish list to reduce inequalities in health, especially where it is backed by £17.7bn extra for the NHS.

    However, several important questions must be asked:

    • To what extent can health inequalities be influenced by health or social service interventions?

    • To what extent are the effects of disadvantage reversible by creating a more favourable climate in health and social services?

    • Are the timescales realistic in terms of generating necessary changes in training and local programmes?

    • Are generations rather than years the timescale to achieve fully some of the targets?

    • Will the inertia both in the services and in the behaviour of individual citizens prove too great a challenge?

    The officers of the Sodom and Gomorrah2 Health Authority may also have been given targets and however lofty their intentions, they were not achieved. Are we being set up for a similar fate? Should we plead for more time as in Sodom and Gomorrah?

    The circular covers the whole range of services for all age groups. In this commentary, I will confine discussion to those targets that relate to children.

    Where are we heading?

    A key objective is “to maximise the social development of children within stable family settings”. While desirable, how can the State in the short term achieve this? Support can be achieved through health visiting and through innovative programmes such as Surestart,3 but the stability of families as a whole might be beyond the reach of the proposed interventions, at least as short …

    View Full Text