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'Saving lives: our healthier nation' white paper

Saving lives: our healthier nation set out the government's action plan to tackle poor health.

The government believed that the wider social, environmental and economic issues had an impact on health, but individuals could take responsibility to improve their own health. The focus was on disease-based targets, rather than addressing the social determinants of health.

The government stated that it would implement local health improvement targets to measure success and performance. The government set national targets relating to:

  • cancer
  • coronary heart disease
  • accidents
  • mental illness.

The paper discussed the introduction of primary care groups (PCGs) in April 1999. The expectation was that once they had been developed into primary care trusts (PCTs), they would lead on local health improvement.

PCGs were made up of multi-professional teams from health, social care and public health. The government committed to:

  • establishing the Health Development Agency (HDA), which would ensure high standards in public health service provision
  • establishing public health observatories (PHOs) in each NHS region to promote public health information and research
  • establishing a public health development fund.

Later developments

The HDA was set up in 2000 as a special health authority to develop an evidence base for improving health and reducing health inequalities. The functions of the agency were transferred to the National Institute for Clinical Excellence (NICE) in 2005.

PHOs were based in each region of England and the UK more widely. They monitored population health trends and provided intelligence and advice to practitioners and policy makers.

PHOs were created in 1999 and the first one opened in 2000 in Liverpool. Though all PHOs had similar remits, they had differing local priorities and focuses. The functions of PHOs in England were transferred to Public Health England on 1 April 2013.


Department of Health.
Saving lives: our healthier nation.
HMSO; 1999.

Hemmings J, Wilkinson J.
What is a public health observatory?
J Epidemiol Community Health.
2003; 57: 324–326.

Department of Health.
Letter to Chief Executives of Health Authorities and Regional Directors of Public Health.
Department of Health; 2000.