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CMO quotes - Public health

  • Last modified date:
    16 February 2007
Public health

"Complacency is perhaps the cardinal sin for those charged with protecting public health. Infectious diseases, once thought conquered, are always marshalling their forces ready to strike back in the face of reduced vigilance. Recent years have demonstrated the remarkable potential for nature to generate new threats particularly when major changes are taking place in the human habitat and in behaviour."

(Sir Liam Donaldson writing in Journal of the Royal Society for the Promotion of Health 2001; 121:146-151)


"Jerry Morris has been an inspiration over his long career. Revisiting the vision in Tomorrow's Community Physician shows that the model of public health he set out in 1969 is as powerful, relevant and far-sighted today as it was then. Over these 30 years, we have struggled to live up to it but it must remain a driving force for change."

(Sir Liam Donaldson writing in International Journal of Epidemiology 2001; 30:1172-78.)



"The advent of devolution will lead to differences in the way that the health systems of the four countries develop in the early years of the next century. All the indications are that this diversity will be healthy with opportunities to tailor services more closely to within-country needs and similarly building on local ideas and innovations. The importance of retaining and developing the traditional bonds and networks between the four UK countries will also be important in ensuring that learning and expertise are shared and that the UK-wide matters (e.g. training and professional self-regulation) are held firmly and consistently together."

(Sir Liam Donaldson writing in Association of Surgeons of Great Britain and Ireland, Yearbook 2000, p39-42. London: The Rowan Group, 2000.)


"Although public health staff who are medically qualified have played a vital role in the development of the public health movement from the first Medical Officers of Health in Victorian England to the Directors of Public Health today, the people who should make up the modern public health workforce will come from a wide range of professional backgrounds."

(Sir Liam Donaldson speaking on 'Strengthening public health' at the national public health conference on building relationships to improve health, in Birmingham, Thursday 28 October 1999.)


"The three legs of the public health stool have always been the biological, the environmental and the social."

(Sir Liam Donaldson writing in Journal of the Royal Society for the Promotion of Health 2001; 121:146-151.)


"Achieving a more effective delivery system also means ensuring a public health workforce which is fit for purpose."

(Sir Liam Donaldson speaking on Strengthening public health at the national public health conference on building relationships to improve health in Birmingham, Thursday 28 October 1999.)


"John Dryden, in his poem, "To my honoured kinsmen ", writes: "The wise for a cure on exercise depend ". This is good advice that the NHS is only just beginning to take seriously."

(Sir Liam Donaldson writing in British Journal of Sports Medicine 2000; 34:409-410.)


"The idea of partnership is not new but new approaches are needed if it is able to address the formidable challenge of improving health and reducing inequalities."

(Sir Liam Donaldson speaking on 'Strengthening public health' at the national public health conference on building relationships to improve health, in Birmingham, Thursday 28 October 1999.)


"The NHS has been and remains a much cherished national institution but one which is changing and adapting to the circumstances of a new century."

(Sir Liam Donaldson writing in Association of Surgeons of Great Britain and Ireland, Yearbook 2000, p39-42. London: The Rowan Group, 2000.)


"There has been insufficient interdisciplinary working across organisational boundaries. Staff from different local organisations and agencies have come together more often in the committee room than at the coal face."

(Sir Liam Donaldson speaking on 'Strengthening public health' at the Public Health Grand Rounds, Goldsmiths lecture theatre, London School of Hygiene and Tropical Medicine, 4 October 1999.)


"Physical activity must be one of the most undervalued interventions to improve public health. Its benefits are great. Physical activity is closely associated with better health and reduced all cause mortality, including reduced mortality from coronary heart disease, stroke, colon cancer, and reduced fatality after a heart attack.

"Exercise helps to reduce blood pressure and hypertension, and can protect against the development of type II diabetes mellitus. It is a vital component of weight control. Weight bearing activity helps to maintain bone mass density and to reduce the risk of osteoporosis; and physical activity generally helps with improved balance, co-ordination, and endurance amongst older people. It has an important role in helping people manage chronic conditions - such as, asthma and arthritis. It also has psychological benefits, including improved self esteem and lower risk of mild to moderate depression."

(Sir Liam Donaldson writing in British Journal of Sports Medicine 2000; 34:409-410.)


"Strong public health needs strong Government. A Government which sees health as both a priority and as a responsibility for all Government Departments not just the Department of Health."

(Sir Liam Donaldson speaking on 'Strengthening public health' at the Public Health Grand Rounds, Goldsmiths lecture theatre, London School of Hygiene and Tropical Medicine, 4 October 1999.)


"The practice of clinical medicine is often compared to a series of detective stories in which the clues to the diagnosis of a patient's clinical problem are investigated. In population medicine, the mysteries of health and disease in entire populations, some extremely complex, are also very challenging. The benefits of solving these problems in terms of delaying death, preventing disease and improving the quality of health care are enormous. To develop the analogy, whilst the clinical detective is pursuing the ordinary criminal, the public health investigator is on the trail of the Godfathers of syndicated crime."

(Sir Liam Donaldson writing in Essential Public Health 2nd edition. London: Petroc Press, 2000.)


"Throughout the last three decades, practitioners of public health have had to sustain the commitment of policy-makers to their field of endeavour amidst a tumult of organisational change. New structures have altered the mechanisms for delivering public health goals whilst the relevance of public health workers has been scrutinised."

(Sir Liam Donaldson writing in Public Health Medicine 1999; 1(3):86.)


"Strengthening public health means that we need to inspire, we need to explain, we need to communicate. We need to create a commitment to change and spelling out the health challenges powerfully and imaginatively helps to create that impetus. Some of the great public health leadership of the past which connected directly with the public and which could influence policy makers is not there in great plenty in today's world, yet it is needed just as badly."

(Sir Liam Donaldson speaking on 'Strengthening public health' at the Public Health Grand Rounds, Goldsmiths lecture theatre, London School of Hygiene and Tropical Medicine, 4 October 1999.)


"Many managers in the NHS have understood the importance of public health but because it has seemed less tangible, a less pressing priority with a more long term agenda than financial and workload imperatives, they have spent little of their skill and energy on implementing health strategy."

(Sir Liam Donaldson speaking at an international conference on The Public Health Context, at Liverpool Moat House Hotel, Tuesday 5th October 1999.)


"During the lifetime of the NHS, public health practice has broadened its traditional scope from preventing and controlling communicable diseases to concerning itself with the determinants of the diseases of modern civilisation such as heart disease, cancer, stroke and accidents."

(Sir Liam Donaldson writing in Journal of the Royal College of Physicians of London 1998; 32: 296-301.)


"I have worked at strategic level in health for 14 years and I can tell you that the sort of data on health inequalities which you view with a familiar or even jaded eye are fresh and shocking to many people. But it is apparent to me that they are not communicated often enough to the people who matter. The people that count are not being shocked into action."

(Sir Liam Donaldson speaking on 'Strengthening public health' at the Public Health Grand Rounds, Goldsmiths lecture theatre, London School of Hygiene and Tropical Medicine, 4 October 1999.)


"Looking to the future of public health medicine beyond the first 50 years of the NHS, further change is inevitable. Public health will become increasingly multi-agency in its orientation and multidisciplinary in its delivery - no longer the sole province of the NHS nor of doctors. Evidence will guide public health policy formulation and the design of practical interventions on a much greater scale than hitherto. Practitioners will need new skills to deliver this style of working. Population screening will throw up even greater challenges associated with the new genetics. Above all, public health practitioners will need to continue to demonstrate their independence of judgement and their fearlessness to champion the causes of the day."

(Sir Liam Donaldson writing in Journal of the Royal College of Physicians of London 1998; 32: 296-301.)


"The process through which need results in a decision to purchase is complex. It involves the extent of need at population level, how that is translated into clinical need, and what the purchaser then chooses to do about it. Each of these stages is subject to multiple influences."

(Sir Liam Donaldson writing in the British Medical Journal 1992; 305:1280-4.)


"The determination of service needs among the elderly largely depends on an assessment of people's capabilities to undertake those activities of daily living necessary to maintain an independent existence, together with the level and strength of family support and social networks."

(Sir Liam Donaldson writing in the British Medical Journal 1986; 293:1079-82.)


"Community services will require not only a great deal of additional resources but a radical restructuring. This must be matched by an adequate thrust in housing policies to develop sheltered housing schemes to allow the frail elderly to live in a state of supervised independence."

(Sir Liam Donaldson writing in the Royal Society of Health Journal 1980; 100: 124-129.)


"In general, activities which divert medical students from this clinical apprenticeship (like public health and epidemiology) tend to be regarded as a distraction and are thus accorded a low esteem."

(Sir Liam Donaldson writing in International Journal of Epidemiology 1980; 9:179-185.)


"The assessment of need in elderly people has been mainly the domain of survey workers, whose results have often been slow to find their way into the armoury of planners and policy makers."

(Sir Liam Donaldson writing in the Royal Society of Health Journal 1980; 100: 124-129.)


"It may seem presumptuous to those whose experience was with the traditional courses in public health, to see the case being made for epidemiology as a foundation science like anatomy or physiology. Yet, it is the logical consequence of the way in which epidemiology has become concerned with a wide range of issues over he last 20 years reflecting the growing importance of chronic diseases as the major health problems of the present and foreseeable future."

(Sir Liam Donaldson writing in International Journal of Epidemiology 1980; 9:179-185.)


"Many of the problems of lack of cohesion, between the different organisations providing services for the elderly, could be solved be evolving a common currency of assessment through which the appropriate type of care could be delivered."

(Sir Liam Donaldson writing in the Royal Society of Health Journal 1980; 100: 124-129.)


"With the impending increase in the size of the population who are very elderly, services which are at present coping inadequately with the problem, will be required to meet the need of an increasing number of moderately and severely incapacitated old people."

(Sir Liam Donaldson writing in the Royal Society of Health Journal 1980; 100: 124-129.)


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