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For years Gross Domestic Product (GDP) has served as a key indicator of human progress and “successful” societies. Unfortunately, GDP has failed to robustly capture the human experience or predict resilience through crises; and obscures the presence of inequity -- a key determinant of suffering. It is clear the global community needs a new organizing principle: one that envisions and measures progress by focusing on the conditions that support health, resilience, and overall wellbeing. This paper examines key health promotion concepts and approaches, juxtaposed with philosophical underpinnings of the concept of wellbeing, alternative measurement strategies, and examples of wellbeing policy initiatives. In doing so, the paper highlights the relevance of wellbeing policy frameworks to health promotion, the utility of health promotion strategies for implementing wellbeing policy frameworks, and controversies and pitfalls that require consideration. The paper concludes by outlining how health promotion is uniquely poised to contribute to wellbeing policy frameworks that promote the sources of human and planetary thriving through sustainable development, and that promoting a wellbeing agenda can strengthen efforts to promote health by addressing social determinants and ensuring universal access to resources that support coping with emerging challenges and strengthen resilience.

Patients should receive copies of letters and summariesEditor-In 2000 we attended a meeting to discuss how to improve healthcare delivery within the NHS. 1 One of the recommendations was that patients, except in special circumstances, should receive copies of all letters, case summaries, or care plans written by doctors or other clinicians. We also suggested that with the patient's approval such material should be stored on a central server. The suggestion was accepted and published in the NHS Plan. The perceived advantages were threefold.Firstly, patients have a right to know what is being written about them and, if such material is to be electronically stored, then they must be informed under the rules of the Data Protection Act and in accordance with the common law on confidentiality. An electronic health and medical record is vital if we are to develop an integrated NHS.Secondly, to refuse to provide such information if this is the patient's wish is to deny their autonomy.Thirdly, patients are often anonymous when they become acutely ill because their history is unknown to the doctor or clinician who sees them in primary care or when they are admitted to hospital. Access to a summary record either carried by the patient or through the electronic record, would overcome this difficulty.The idea that patients should receive copies of letters and summaries is not new, and research has shown that it meets with high satisfaction from the patients. 2 The proposal was approved by the Joint Consultants Committee subject to certain safeguards. We assumed that recommendations from the profession and the Department of Health would follow and the practice would be introduced throughout the NHS without delay.Not so. We have learnt recently that a committee set up under the NHS Modernisation Board has now recommended further research.3 Given the urgency of developing electronic medical and health records we wonder why any particular difficulties in recommending the practice nationally could not be sorted out through "action research"Correlation between duration of consultations in minutes and numbers of things patients wanted and got from their consultations (n=201) What patients wanted What patients got Use of Swiss paediatric emergency department has grownEditor-Santos-Eggimann suggests that the increasing use of the emergency department in her Swiss hospital is mainly associated with an ageing population and immigration. 1 The emergency department she analysed serves mainly adult patients. Her conclusions do not necessarily apply to children.We recently reported the dramatic rise in the use of 10 state run paediatric casualty departments in the French speaking part of Switzerland, the region where SantosEggimann's analysis was performed.2 This increase (median 113% (range 16-264%) during 1990-9) is obviously not linked to a so called ageing population. Other causes have to be considered. We report here the dramatic increase in the use of our paediatric emergency department and offer an explanation for it.Our district ...

The Ottawa Charter for Health Promotion represents a turning point in public health thinking. The key messages and approaches, such as 'enabling, mediating and advocating', of this historical paper have not lost their timeliness and they are still considered to be the lessons for those health policy-makers who are willing to move beyond the health sector and to push health higher on the political agenda.

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