Bibliographical noteFunding Information:
The unexpected decision to propose a complete reorganisation of the NHS has already led to disruption to the function of public health in some places, such as in NHS North West London. 21 The current proposals will create further disruption that, we believe, can be mitigated—and thus avoid destabilisation at a time of historic change within the NHS. The government calls for a public health system that can deliver world-class outcomes. We believe our model is more likely to achieve this goal than the government's proposal. Importantly, our model is consistent with the core aspects of the government's draft legislation and its stated principles of enabling public health to fully engage with the work of local authorities and Commissioning Consortia. Our model can secure a strong public health workforce that can attract and retain high-quality graduates, working effectively within the localism agenda, while safeguarding against the threats posed by the government's proposals to existing and future capacity. Members of the Commons Health Committee, from all main parties, have already expressed concern about the proposed legislation, promising “significant parliamentary scrutiny”. 22 We hope that our alternative proposals will assist this process. Contributors MM, LH, and RA drafted the paper, which was revised by all authors. Conflicts of interest MM has advised the Department of Health on aspects of the NHS performance framework. LH was on a placement at the Department of Health from April until October, 2010, and worked with the Public Health Development Unit who are setting up the Public Health Service RR is in part funded by the NIHR UCLH/UCL Comprehensive Biomedical Research Centre. IW is the wife of The Lancet 's Editor, who took no part in the peer review or decision making process for this Viewpoint.