Who should set the example?


Deborah Glover - Editor PCNR

BSc (Joint Hons), Dip. Care Policy & Management, RGN

Public health - no need to worry?

I've recently been having a LinkedIn chat about funerals, and had suggested that while I am happy to leave my body to a bunch of medical students, I don't wish to do so just yet. However, this post may result in many of you wanting to help me on my way...

Why? Because I'm about to suggest that it's about time healthcare professionals stopped facilitating life-style diseases and that the public start to value the NHS...

But the public do value the NHS I hear you cry. After all, the NHS and immigration seemed to be the only two policies any political party discussed in the run-up to the recent election. But aren't some just abusing it?

According to Simon Stephens, much of the obesity crisis and the rise in other avoidable diseases is down to us (http://totalassist.co.uk/nhs-chief-warns-of-rise-in-avoidable-diseases/).

Perhaps this is an arguement for charging to see a Dr.

The fact is people of my grandparent's generation rarely called a Dr because it was expensive. Appreciating that rationing etc existed, which in many ways, made the UK a much healthier nation, they knew that they had to take care of themselves because treatment was expensive. Today, there is no incentive to take care of oneself because we know that the NHS will fix us, whether our illness is due to a lifestyle choice or an unavoidable cause. Dental care is free for children, yet the UK has one of the worst records for child dental health, with total clearance not unusual in under 10’s. Blaming sugary drinks is disingenuous – whether the child has one drink or fifty drinks a day, there is no reason they can’t take care of their teeth and visit the dentist every 6 months.

The rise of bariatric surgery, bariatric beds, bigger ambulances, heavier lifting equipment, etc is another example; I wonder sometimes if by 'responding' to an issue we create one - rather than encouraging people to exercise and eat well, we have created a whole speciality - so where is the incentive to lose weight if you will be dealt with no matter what your size? However, if I take that particular cynical hat off, health professionals still have some culpability. If we feel we can't tell someone they are overweight (and NICE don't think we should), or shouldn't smoke, or eat sugar, we are failing in our duty to help promote health. But then again, nurses and doctors and other healthcare professionals are just as much a reflection of society. One rarely used to see overweight nurses/policemen/firemen. Now we see a lot, so how can we promote public health when we clearly don't set an example?

Taxes on sugary drinks and 'unhealthy' foods are not the answer. That just penalises those that do eat/drink responsibly. And let's be honest, alcohol and tobacco are taxed to death, but it doesn't stop people smoking and drinking, even when they can't afford it. The whole concept of the NHS was that it would complement a healthier society, only treating the sick. Public health and health promotion were meant to ensure that the population stayed reasonably healthy. Somehow though, health promotion and public health are not something the public tend to engage with! Probably because it's boring and once certain things become acceptable or the norm, one ceases to worry about non-conformity.

We have a mountain to climb - without crampons