The status and tasks of public health medicine in England in 1991 and 1993.

Two national postal surveys of directors of public health, the first in 1991 and the second in 1993, looked at the extent to which HC(88)64 had been implemented. Response rates for both exceeded 80%. In 1991 virtually all health authorities had, as required by the circular, appointed directors of public health and had annual health reports published. It took until 1993 for the requirement for collaborative work to be more firmly established. More work with FHSAs is now needed, together with effective use of extensive provider involvement, if HSG(93)56 is to be achieved.