Monday, 11 February 2013

On the cult of public health...


The transfer of public health from the clutches of central government and the NHS presents a real opportunity. An opportunity to appraise what it is we mean by ‘public health’ and how those considerable sums - £31 million in Bradford’s case – should be spent. Sadly, this won't happen.

Some while ago public health was captured by an aggressive, new puritan cult intent on using government funding to change the way people choose to live. This attack on the lifestyles of ordinary people is founded on a few principles:

  • Denormalisation – the idea that those making certain choices should be ostracised since this will force them (assuming they want to be ‘part of society’) to change their wicked ways. This strategy is most advanced in the case of smoking (and anything that even looks like smoking) but the template of denormalisation is now applied to drinking and to eating certain sinful foods
  • Government health spending is for the good not the evil – sinful people who smoke, drink and eat burgers, who might be a little short of breath or a couple of stone overweight represent a burden on health services meaning that the righteous do not receive the care they need. We should stop people smoking, drinking and eating burgers – not for their own good but for the ‘good’ of the NHS
  • The poor can’t help it – far from the choice to smoke, drink and scoff Gregg’s sausage rolls being just that, a choice, it is in fact the fault of the makers of these products – “Big Tobacco”, “Big Food” and “Big Drink”. The poor are like helpless sheep thoughtlessly trotting into oblivion, responding to the sirens voice of advertising and the manipulation of faceless, besuited men
  • Medicalisation – smoking, drinking, eating the wrong stuff – even sex – can be treated with medicines. And the pharmaceuticals industry has spent a great deal of time – and money – creating new illnesses and new conditions that require drugs. Thus conditions such as “female impotence” arrive following pharma funding and their capture of researchers and clinicians. This medicalisation underscores denormalisation by making lifestyles an illness rather than a choice.

And the application of these principles has now spawned a vast industry:

‘The NCD Alliance, a global advocacy organization representing a network of more than 2,000 civil society organizations led a major lobbying campaign, and mobilized its network to ensure this target was secured.’

These aren’t noble volunteers we’re speaking of here but committed campaigners paid by these ‘civil society organisations’ to lobby government and international organisations such as the World Health Organisation. And much of that funding comes from either the very governments being lobbied or from those who benefit from the medicalising of normal conditions.

Public health long since stopped being about great programmes such as building sewers, immunisation and clean air. Instead it has become a bitter little profession dedicated to finding fault with the choices that ordinary people make, with punishing them for enjoying a few simple little pleasures and with hectoring us about our lifestyles. None of this is really about our health. Rather it is about sin - about disapproving of what we do, of believing that the focus of our lives should be the search for eternity. Not in the afterlife but here on Earth.

And the believers in the public health creed say that this is done by a purposeful life dedicated to well-being - to the rejection of hedonism and its replacement with the comfort blanket of a false contentment. But worse these believers whip up hatred and disapproval of anyone who rejects their search for eternity, who believes that we only get a short time living and that our first duty is to have as much fun as we can in that short time.

This dreary and depressing cult is enough to drive you to drink!



Unknown said...

A problem caused, al least in part, by our elected representatives deciding that their job is no longer, apparently, to represent our wishes.

SadButMadLad said...

Steve, it's not so much our elected representatives doing more than they are elected to do, as the unelected doing things that they think should be done. The unelected use the elected to get laws changed etc, but it's the unelected who are doing the nannying. They are the ones who want to make their empires bigger by controlling more of the population be it by health, food, activity, pleasure, and even thought. All to get more public money for themselves.

Unknown said...

I kind of agree SBML, but if the elected simply turned round and told them where to go, which would probably reflect the views of the electorate, then they wouldn't have an empire in the first place, let alone one to enlarge.

Jonathan Bagley said...

Excellent article Simon.

Junican said...

That, chaps, is the reason that Tobacco Control etc have the fake surveys - in order to persuade politicians that the public is behind them.