In January 2006 the Department of Health published Our health, our care, our say: a new direction for community services. It is the government's seventh White Paper on health since coming to office in 1997 and, after several years of reform aimed at the acute hospital sector, it represents what Patricia Hewitt, the Secretary of State for Health, calls a 'fundamental shift' towards integrated services provided in local communities. The government's rationale for this shift is that it is popular (people want more convenience, better access and more local co-ordination between services); it is cost effective in the short term (avoiding costly hospital treatment); it is better quality (reflecting technological changes) and it will save money in the longer term (better prevention now will avoid costly illnesses later). This briefing outlines the main policies in Our health, our care, our say and offers some analysis of it. [Introduction]