Sunday 10 May 2020

Public health failed us...comprehensively and catastrophically (but nothing will change)


 Public Health England has, as its first purpose, the task of protecting the nation from infectious disease. You'd have thought that an agency with over £3 billion to spend would have been a little better prepared for a pandemic.

There's a reason. Public Health England, cheered on by the wider public health profession, by the NHS ideologues obsessed with "prevention" and by a cacophony of media know-alls, spent 87% of its budgets on something other than protecting us from infection and preparation for epidemic.
PHE’s budget for ‘protection from infectious diseases’ rose from £52 million in 2014/15 to £86.9 million in 2018/19. There have been no cuts in this crucial area. Still, £86.9 million is only 2 per cent of the public health budget. If you include routine vaccination programmes, the amount spent protecting the public from infectious diseases rises to 13 per cent.
If you want to get angry about response to pandemic, don't focus simply on the decisions taken now in the face of a pandemic, look at decades where the official public health position was that the big problem is now NCDs - "non-communicable diseases" - by which they mean drinking, smoking and eating the wrong sort of food. Billions of health cash was splurged on ineffective campaigns to get us to lose a few pounds, to browbeat recalcitrant smokers into quit programmes that mostly don't work, and to nanny the hell out of all for choosing to drink 15 units of alcohol in a week.

I don't expect anything much to change, the ideology of modern public health infects not just those it employs but legions of councillors, doctors, whitehall bureaucrats and MPs who like nothing more but a good nag at ordinary folk for daring to do things those ideologues have decided are a sin against the cult of health. As the coronovirus epidemic wends its inevitable way, it has been accompanied by a steady drip of statements from the usual public health culprits about how the disease shows we must drink less, stop smoking, eat only the approved diet and indulge in all sorts of exercise. We're told, of course, that this will "protect the NHS".

There'll be a perfunctory few little campaigns about disease control ("wash your hands", "use a tissue") but these will pass as the public health ideologues return to their real love - telling people their lifestyle choices are bad for their health and, by implication, a crime against the holy NHS. Endless, ill-informed and unquestioning media reports will be aired explaining how we're all too fat, how vaping is a really bad thing, how having even a sniff of white wine will kill your baby and how we should all get bicycles so we're super fit when the white van kills us.

At the start of this epidemic the public health business, from the WHO down to local council fussbuckets, stood there like frightened rabbits staring unblinking at the virus as if this wasn't something that people had predicted might happen. These ideologues - obsessed with getting government to regulate your life - simply weren't ready, had made no preparation and allowed the misinformation of an authoritarian communist government to determine international policy. At the local level - across just about every developed world country - public health hadn't even bothered to included epidemic response in its plans and strategies. Plenty of room for quit smoking programmes that don't work but barely a mention of what we'd do faced with a pandemic.

Sometime in the coming year there'll be a reckoning. Sadly it'll be the wrong kind of reckoning as the public health ideologues will be the ones asked to write it. What we'll get is how if we had better "general health" (code for not smoking, drinking or eating beefburgers) then we'd be less susceptible to an epidemic, followed by a redoubling of the same fussbucketry about your lifestyle.

If I was in charge of a local council public health budget, I'd be shifting pretty much all of it into programmes aimed at shielding the old and vulnerable from infection plus improving the care we provide for such folk. That would, however, actually help so don't expect the control freaks who run public health, the busybody council leaders, the lobby-victim MPs or the lazy media to do anything other than carry on with the current, officious and ineffective public health policy.

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5 comments:

Anonymous said...

I reckon this is a symptom of something that's liable to happen in many large organisations, but most especially in well-funded public administrations. They simply attract all the wrong sort of people. Anyone with a good career and prospects in the direct line of business, whether it be science, education, whatever, tends to want to stay in that discipline. Why give up a treasured career as a top class professional to go and be a stooge, however well paid? The folk who are mediocre though, who know they will never get to the top of their profession, are attracted to the path of administering their sector. It's easy for a start, nagging and scolding the public, generating reports whenever their treasury paymasters want a pretext for hiking our taxes, they never dreamed they'd have to deal with a real health emergency. We shouldn't be surprised that the task is beyond them. Their normal modus operandi consists only of instigating campaigns, it's impossible to get that wrong. But now they have been dropped into a real crisis and we can all see how they are floundering, obsessed with protecting their turf, and fending off genuine help that's sprung up in the private sector.
Maybe we need sunset clauses, forcing the periodic dismantling and the renewal of these administrations. Not just in the UK, there's a lot of dross decomposing in the UN too.
Monty

Nessimmersion said...

The biggest joke on public health and their campaigns is the protective effect of smoking.
So logically we should open up resteraunts, bars, etc to smokers only, as they already have protection.
https://velvetgloveironfist.blogspot.com/2020/04/smoking-is-not-risk-factor-for-covid-19.html?m=1

A K Haart said...

Very well said - I've been there and I know the type. Often well meaning but entirely subservient to the fashions of the day.

Andrew Carey said...

Well said - there was a pre CV-19 analysis which suggested making it compulsory to wash your hands for 20s before exiting an airport would have a major effect on delaying spread of viruses. Today we find taxi drivers are in the joint highest risk group of those of working age of dying from this thing. Public Health should have been on this simple opportunity.
And if we can have pop up bike lanes, why not pop up hand washing points outside other transport hubs.
Their interest in keeping us safe is like the interest of women on dating sites in men without money.

Stonyground said...

The problem with such bureaucracies appears to be perverse incentives. The organisation's purpose is supposedly to improve the overall health of the nation. The problem is that they get more money if the nation's health is perceived to be worse. Hence masses of advertising revenue spent on propaganda about how overweight and unfit we all are. Meanwhile, doing anything to improve things must be avoided at all costs.