This paper reviews the position of health promotion in England and, in particular, how structural change and reorganisation within the NHS, along with the emergence of multidisciplinary public health, have been a challenge to its identity. It draws lessons from recent experience to emphasise the distinctive contribution of health promotion to public health and the need for proper recognition and career progression for health promotion staff. It argues that the specification of competences should be informed by a health promotion discourse and that as well as defining skills these should also include the values and ethical principles of health promotion. It argues that practice should be evidence-based and health practitioners have a responsibility to draw critically on evidence and also to generate the type of evaluation evidence which would inform dissemination.