The return to local government on 1 April 2013 of a responsibility to improve the health and wellbeing of local people is welcome. Councils, through the services that they commission and deliver, already have an influence over the day-to-day conditions in which people live, so they are well placed to make the most of a move away from a medical modelof health, based on clinical treatment, to a social model, based on health promotion, protection and disease prevention.
They will need to use every power, department and service at their disposal, however, if they are fully to grasp this opportunity and tackle the causes of the causes of poor health: the social, economic and environmental reasons why people experience ill health or develop unhealthy behaviour. Central to the new system will be Health and Wellbeing Boards, whose members include councillors, GPs, directors of local services and community groups. They will need to focus on health promotion among all age groups, not become constrained by an undue focus on health and social care commissioning and integration. With few powers and no budget to commission services themselves, they will have to display leadership, build relationships and use their influence locally to turn their health and wellbeing strategies into reality