Sunday 28 August 2011

Public health - we don't need a cosy consensus but a real debate

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The IPPR, that cuddliest of social democrat apologists for big government, is suggesting that public health needs a 'consensus' approach:

The only way public health outcomes can be improved in the long term is to develop a cross-party approach, according to a think-tank report.
The report, written by IPPR senior research fellow Phil McCarvill, calls on the main political parties to commit to the development of a “long-term vision and strategic approach to public health”.

This is a classic Fabian approach - by turning decisions on public health from policy choices to strategy implementation we no longer have a political debate about the purpose of public health. Crucially this would mean that, following the transfer of responsibility to local councils the focus wouldn't be on what councillors want but on the administration of the public health programme on the basis of a local Joint Strategic Needs Assessment.

I want a real debate not a cosy "cross-party approach". A debate that allows us to argue for policies that respect people's lifestyle choices, that work to reduce harm and that stress environmental contributors to ill-health such as poor housing, air pollution and mental health rather than condemning the personal choices of ordinary people.

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3 comments:

Pat Nurse MA said...

It's not about health. If it were, they would not be legalising discrimination and exclusion of those in need of medical care because they have lifestyles the puritans find unacceptable.

I am really distraught about this
http://patnurseblog.blogspot.com/2011/08/selective-nhs-abandons-those-in-need.html

Anonymous said...

Lifestyle

Smoking and the sea change in public health, 1945-2007

"Today's alliance between doctors and the government to influence individual lifestyles is a relatively recent phenomenon.
First, it required the medical profession to abandon its culture of secrecy, based on patient confidentiality: this began with the use of television in the late 1950s.

Second, it required the introduction into public policy of studies linking lifestyles and health risks: this began with a change in leadership at the Royal College of Physicians in the early 1960s.

Third, it required a shift in the nature of public health from local information giving to central publicity campaigning: this began with the Cohen Report on health education in 1964, advocating a rethinking of the profession of health educators as persuaders, even salesmen."
http://www.historyandpolicy.org/papers/policy-paper-59.html


Liquor:Gentlemanly Temperance
Monday October 07 1935

"In the two decades before Prohibition, those lifelong teetotalers John D. Rockefeller Jr. and his father gave the Anti-Saloon League their stanch moral support and $350,323.67. When he declared for Repeal in 1932, Mr. Rockefeller by no means meant that he was quitting his long war on liquor.
Having despaired at last of temperance by statute, he set his agents searching the world for other methods of attack."


"Our messages will travel over the airwaves, reach the eye and ear through the screen and stage, and fashion public thought through advertising and other kinds of publicity."
http://www.time.com/time/magazine
/article/0,9171,755063,00.html



Rockefeller Medicine Men - Brown

BLAMING THE VICTIM: NEW PROMINENCE
FOR AN OLD IDEOLOGY

"The cost of sloth, gluttony, alcoholic intemperance, reckless driving, sexual frenzy, and smoking have now become a national, not an individual, responsibility, all justified as individual freedom," asserts Dr. John Knowles, the influential president of the Rockefeller Foundation.
"But one man's or woman's freedom in health is now another man's shackle in taxes and insurance premiums."
http://www.soilandhealth.org/03sov/0303critic/030312brown/brown5.htm


Medical Research Council
Rockefeller Medical Fellowships
1932
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2520659/pdf/brmedj07385-0032a.pdf


1945-1946
"Rockefeller Foundation offers fellowships for training "hand-picked" students in Public Health Department.
Introduction of lectures on sociology and social medicine."
http://www.lshtm.ac.uk/library/archives/history/chronology/


1962
"The civil servant Enid Russell Smith, always an incisive analyst of events, commented in 1962 that government could draw in future on two things: parents' concern for their children, and the changes taking place in the medical profession.
Publicity would have the authority of the profession.

So far, she commented, the state had not sought to protect individuals from doing harm to their own health if they were not harming the health of others; alcohol was an exception to the rule, and also drugs of addiction, but for both it was the social consequences rather than individual health that was paramount.

The new line might be that the costs fell on the state, and so government should stop people from damaging their health—but, she commented presciently, once government took on this role, it would not stop at smoking"
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1894742/

Anonymous said...

Public Health

"The new School of Hygiene & Tropical Medicine was opened in its present building in Keppel Street, a gift from the Rockefeller Foundation.

At that time, the term 'hygiene' was not restricted to its current meaning of 'cleanliness' or 'sanitary science', but was used in the wider sense of the establishment and maintenance of health - now more usually described as 'public health'"
http://www.lshtm.ac.uk/prospectus/introduction.html


Interesting snippets from America in 1949 where the plans for socialised medicine had apparently been rejected repeatedly.

Socialized Medicine

"Four percent of $2,263 means that each wage earner will be compelled to pay $90.52 to Mr. Ewing to have his health insured. Something the Administration propagandists for Socialized Medicine have NEVER TOLD US is that one third of these 59,378,000 wage earners are already insured under efficiently managed health insurance plans of the Blue Cross and other privately run co-ops.

The Blue Cross charges each individual insuree 80c a month for his medical insurance and $1.10 for hospitalization. He can get both for $1.90 a month, or $22.80 a year.

Yet the Ewing Plan proposes to slug four times as much out of him for "health insurance" whether he wants it or not."

"A report from England gave the Drug Trust much joy.
Since Britain's Socialist government had socialized medicine, and made pills and drug concoctions "free," the British people had tripled and quadrupled their consumption of these unnatural products.
Pill swillers — the British people are being called."
http://www.nccn.net/~wwithin/TheDrugStoryBeale.htm#Socialized_Medicine_



GREAT BRITAIN: Medicine Man - TIME
Monday, Mar. 21, 1949

"In Britain, at least, there was no longer any point in warning citizens that they were selling their birthright of freedom for a mess of pottage. Bevan, the bulldog breed's new vet, could reply that Britons could eat tastier, tougher fare than pottage now that they had got new false teeth from the health service."

"Look into the Future. Some observers believe that the social welfare state may destroy democracy in Britain and pave the way for Communism. Others say it will provide the best bulwark against Communism, by preventing the want and insecurity on which Communism thrives."

"Bevan says the party is like a man on a bicycle: if he stops he will fall. According to his own statement, Bevan will settle for nothing less than "total destruction" of the remnants of British capitalism, including the Conservative Party. He has estimated that completion of his program will take 25 years."
http://www.time.com/time/magazine/article/0,9171,933793-1,00.html