A New Social Contract for Public Health

The fundamental question at the heart of public health policy is how it can be that cost-effective measures to promote the health of the population are not more vigorously implemented. The question has become more urgent as the pressures on the NHS have increased. Behind the implementation deficit, this chapter examines the role that a dominant public philosophy of libertarianism has played. That public philosophy is plagued with a number of problems, and in its place this chapter argues for a philosophy of social individualism in which the role of government-provided public goods is central to creating the conditions for effective individual choice and fulfilment. The chapter concludes with a manifesto of practical public health measures.