That is because its job is to protect and promote the health of populations rather than treating diseases, disorders and disabilities in individuals.
It is about using evidence-based prevention and intervention strategies (has Associate Health Minister Casey Costello read this?) to help communities grow their own ability to address the issues that affect their population, the website says.
That fence is not looking particularly flash just now.
Rather than being the sort of impenetrable fortress type of structure you might see around a gang pad, it’s more like a saggy old wire fence with half the battens missing and skew-whiff strainer posts.
You might think if we wanted to help keep as many people as possible out of our increasingly expensive and overworked hospitals, governments might be prepared to spend up large on a broad range of initiatives in this area.
Such spending could also benefit our struggling primary care health services .
However, this has not been the pattern of successive governments which have failed to have a comprehensive and bold approach to public health, particularly in areas where it might affect big business.
There have been glimmers of hope such as the previous government’s smokefree reforms, but we all know how they have fared since the coalition government took office.
One public health area where the government is keen to make a difference is in raising the level of childhood vaccinations.
In connection with this, last week the government announced a pilot programme which would see Whānau Āwhina Plunket nurses trained to deliver childhood immunisations at up to 27 sites across the country.
It will be great if immunisation rates reach the target of 95% of children being fully vaccinated at 24 months, but what then for child health?
Although the health strategy published last year said unhealthy weight and high blood sugar were in the top five risk factors for health loss and premature death and had grown significantly, and alcohol use and dietary risks were in the top six and had also grown, a cohesive plan to deal with these risks is still not evident.
The quality and reach of the school lunch programme is under threat and we are no closer to having sugary drinks banned from all schools.
A consultation on the latter showed there was considerable support for a ban, but the Labour government held off implementing one to do more work on how it might affect secondary schools.
The latest reporting on this suggests there is little enthusiasm for this in the coalition government, with Education Minister Erica Stanford saying it was not priority.
Since this government prides itself on getting things done, and it moved rapidly to ban cellphones in schools, it is disappointing it cannot see the urgency for this public health nudge which would have an impact on dental health and nutrition.
In the longer term it could also contribute to lowering obesity rates and type 2 diabetes.
Alcohol harm prevention is another area where successive governments have been loath to take action which will have the most impact.
It is fascinating to compare that with how much attention has been focused recently on the need to put greater controls around the sale of nitrous oxide (also known as nangs) which has been described as our least harmful drug.
Any hope for a coherent plan to shore up the fence at the top of the cliff seems remote, given the recent news the National Public Health Service may be facing funding cuts, even though it only receives about 1.5% of the health budget now.
We agree with executive director of the Association of Salaried Medical Specialists Sarah Dalton who says any suggestion that what public health staff do is secondary to an effective health service is outrageous.
