Congratulations on your appointment as minister for public health. You have two options in this role: you can be like all the other ministers for public health, both Labour and coalition, and allow the role to be just one among many in the health department, subservient to the more glamorous world of NHS hospitals and doctors’ contracts. Or you can transform the way the government sees public health, and make your role one of genuine cross-government leadership to ensure people live longer and happier lives.

We know that health inequalities scar our society. Nothing is more emblematic of unfairness in our society than the differences between rich and poor in their health. The poor are healthier for fewer years than the rich; the poor die sooner than the rich. A child born today into an ABC1 family is more likely to live longer, and be healthy for longer than a C2DE child born in the same hospital. The three landmark reports into public health that Labour secretaries of state have commissioned over 30 years – Black, Acheson and Marmot – all point to the same thing. Our health is determined by our wealth.

So as public health minister you may want to take up all those photo-opportunities for taking up jogging, quitting smoking or brushing your teeth that the Richmond House press office will stick in your diary. Or you may want to be a radical, reforming minister who actually starts to narrow the gap in life expectancy.

If the latter, the first epiphany you need to undergo is to understand that the NHS has failed to tackle health inequalities. Within a couple of decades of the NHS’s foundation, social scientists and sociologists noted that health resources were being skewed towards affluent communities. Dr Tudor Hart’s famous ‘inverse care law’, noted in the Lancet in the early 1970s, that the people most in need of decent health care are the very people least likely to be getting it. So we need to reform the NHS so that it is genuinely equal in its treatment. That means more clinics and services in poor areas (including primary care), more services tailored to the conditions and diseases of poverty, and more investment were the needs are greatest (not just were the local campaigns are loudest).

But the second epiphany is that the NHS and ‘public health’ are not the same thing. The NHS can be a tool to help deliver the latter, but not the only one. Much of the public health budget rests with local authorities now, and most seem a little uncertain how to spend it. The smoking ban is a good example of a public health measure which had little to do with the NHS. You must reinvigorate the cabinet committee on public health, and ‘health check’ (literally) every piece of legislation and regulation. That might include everything from extending the ban on cigarettes to private vehicles, to the design of new towns to encourage cycling and walking. It means a new emphasis on mental health services, more work on diet and obesity, a grown-up national conversation about teaching sexual health and relationships in our schools, a review of the use of tranquillisers by GPs, new approaches to drug and alcohol addiction and new initiatives to end the smoking of tobacco.

We’ve tried in the past to create central agencies for public health. You’ll need a central agency such as Public Health England. But far more exciting should be the chance for developing local centres and agencies. Agencies like local NHS walk-in centres, healthy living centres, and sure starts need re-establishing, with a licence to innovate, and local cooperative control. You could look again at health action zones, and learn from their successes. Never forget that the Attlee government wanted a network of healthy living centres in the poorest communities, along the lines of the Finsbury health centre built by the council in the 1930s. Its dream was never realised.

Few areas of public policy do not come under the reach of public health, from jobs to supermarket design. Intervene in all of them. You can be the first public health minister to end public health’s Cinderella status in Whitehall. The plain fact is that the NHS was conceived and designed at a time when poverty meant diseases of malnutrition, work meant industrial injury and diseases, and society pushed mental and sexual health under the carpet. We’ve come a long way, but the next Labour government must act on all the evidence and experience, and genuinely transform the lives of the poorest people in our community.

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Paul Richards is a Progress columnist; read his columns here. He tweets @LabourPaul

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Photo: John Goodridge