Introduction: learn to talk like me and be an angel too

New Labour came to power in 1997 to the theme of D:Ream's ‘Things can only get better’. As the lyrics to its campaign tune said, it thought that it had found the cause of all that was wrong in Britain and that it was the party that would be the cure to the disease of prejudice and greed. It was going to be an angel – and things could only get better.

Prior to 1997, throughout the long 18 years of Conservative government, Labour had referred to the issue of increasing social inequalities in health as an area of particular concern. Thus it was surely a good sign that before the May 1997 election it had announced that it would launch an independent inquiry into inequalities in health. The inquiry was launched in July 1997, with Tessa Jowell, the new Minister for Public Health, criticising the health strategy of the previous administration for ‘its excessive emphasis on lifestyle issues’, which ‘cast the responsibility back on to the individual’ (DH, 1997). She gave a commitment regarding the inquiry's findings that these ‘conclusions, based on evidence, will contribute to the development of a new strategy for health’ (DH, 1997).

The independent inquiry report duly appeared (Acheson, 1998). It presented a wealth of evidence on the extent and trends of inequalities in health. This, together with a large body of other evidence drawn together in the report, demonstrated clearly that the previous two decades had seen large and growing inequalities in income in Britain, and that these had been accompanied by equally stark increases in health inequalities and in life chances more generally defined.