Current political changes to the British National Health Service and the development of nursing as a profession contribute to the individualization of health. Such trends view the client as a victim of his or her behaviour and encourages a form of health promotion which focuses on the individual and ignores or decontextualizes social problems. Nursing needs to examine issues of power and control in health promotion encounters and not simply view health promotion as benign encounters. Health promotion practice needs to focus not on the development of skills as the central component but on the relationship between the nurse and the client. A simple shift in nursing from using communication skills to persuade, to using counselling skills does not evade the charge of victim blaming. Health promotion needs to place health and its influences within a context.