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Robin Stott proposes solutions to the key problems that beset our present health system. He argues that if we are to develop a true public health service rather than a 'disease service', we must make radical changes to the decision-making processes. We need to acknowledge the health impact of many factors including the distribution of wealth, the size of communities, lifestyle issues, local pollution and the condition of the whole planet. The briefing shows how enhanced interaction between people can promote health, social justice and environmental improvements; and sets out a blueprint for local health improvement organisations.