It seemed a good idea to transfer public health responsibilities from the NHS to local government back in April 2013. After all, decades ago the medical officer of health was part of the local authority. Indeed the entire foundation of local government was based on public health, reducing epidemics, bringing in clean water and clean air, improving housing and sanitation. With its modern, albeit reduced remit, local government still has direct influence over the preventative aspects of public health in leisure, parks, social services, the environment and housing.

Since 2013, following Andrew Lansley's downfall as health secretary, it is clear that the Government has changed its mind about local government's public health responsibilities and sees a top-down role as more effective. It is reasonable to conclude that legislation banning smoking in public places has had much more effect on health than any council's anti-smoking cessation programmes. The sugar tax announced in the budget is another example where the Government has concluded, under pressure, that childhood obesity is better tackled through legislation rather than every council sticking leaflets up in school common rooms and civic centres and hoping they will be eagerly studied by cola-guzzling students. Now NHS England has launched its own drive to reduce diabetes among older people.