The appointment of directors of public health (DsPH) to the Primary Care Trust(PCT) boards to work jointly with the local authorities in addressing health inequalitiesre”ects the adoption of a multidimensional perspective of public health,and a shift inpolicy focus from treatment to illness prevention.Neo-institutional theory of change isapplied to discuss “ndings obtained from a postal questionnaire with all DsPH (n=40)and qualitative interviews with executive and non-executive board members in “vePCTs in the NorthWest of England,and to conclude that public health potential maynot be ful“lled because of pressures outside the public health area and the lack ofcapacity in the PCTs.