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CAMPBELL: It is right that we should be responsible for our health 

Is Andrew Lansley happy with anything about the way healthcare is organised and delivered? It seems not. First, he produced an NHS reform white paper to radically alter Nye Bevan's creation in ways that would horrify its founding father. Then, on Monday, he announced a major cull of health quangos. He also plans to bring a similarly unforgiving eye to public health – the messy, politically sensitive and sometimes fatal business of food, drink, drugs, smoking, infection, driving habits and sexual behaviour.

His speech on 7 July to the annual conference of the UK Faculty of Public Health (FPH) will be . . . "We have to find a new approach – to think new thoughts. We need a paradigm shift," he said.

Central to his new approach will be a reliance on more people showing more personal responsibility: eating more healthily, exercising more, no longer drinking more than is good for them and so on.

Lansley wants to reduce the growing demand on the NHS, and points out that "nearly a quarter of the deaths in this country each year result, in part at least, from the consequences of unhealthy lifestyle". He has set himself a very big challenge. "We have to impact on demand. That means we have to change behaviour, and change people's relationships with each other, and with drugs, alcohol, tobacco and food," he said.

This is challenging, politically bold, stuff. . . .

It will be fascinating to see how he intends to encourage the greater discipline he says is needed. By exhortation? Unlikely, given Lansley's rejection of "nannying and lecturing". Through financial incentives, such as those used by primary care trusts to get people to lose weight or take a chlamydia test? Or by threat, such as making access to public healthcare conditional on behaviour change or paying charges? Lansley's answer involves incentives such as pedometers, which increase users' physical activity; telling smokers their "lung age", which makes them more likely to quit; and his belief that "advertising social norms can snap people out of the fantasy that their drinking, smoking or eating habits are the same as everyone else's". Public health has just got personal.

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