Posts tagged with Coercive Healthism

As a medical student, Dr No was greatly impressed by a particular surgeon. This surgeon was that rare thing, a surgeon whose mind was even sharper than his scalpel. He taught Dr No perhaps the most important surgical lesson of all: that surgery is not about how to operate – any competent surgeon can do that – it is about when to operate; and it is fidelity to that decision that distinguishes the great surgeon from the average surgeon. That same great surgeon taught Dr No much else, often in the vernacular, and none more certain than that which holds that the only sure-fire way to advance one’s medical career is to apply regular and consistent negative pressure at the anus of one’s superiors.

‘The only function of public health,’ JK Galbraith might have said, ‘is to make cranial osteopathy look respectable.’

Such a thought occurred to Dr No as that tiresome quango, the National Institute for Health, Clinical and Anything Else Anybody Will Pay Us For Excellence dumped not one but two unwelcome coils of public health ‘guidance’ on an unsuspecting public this week. One was old hat – salt and saturated fat are bad for you, flogged into new life in NICE’s inimitable way (‘Tens of thousands of lives could be saved, and millions of people spared the suffering of living with the effects of heart disease and stroke, simply by producing healthier food says new NICE guidance’). The other was something altogether different. Pregnant women who smoke, NICE declared, can’t be trusted to tell the truth, and so the truth must be forced out of them, if necessary by coercion:

Warning: post contains economics. Some readers may find themselves bored silly. In such cases, Dr No recommends taking a tea-break and returning to the post only when the sense of boredom has completely dissipated.

Economists are keen on a concept known as elasticity. There appear, from Dr No’s primitive researches on the matter, to be a disconcerting number of elasticities in economics. Naturally enough, economists dress all these elasticities up in hieroglyphics, but inspected through the lens of common-sense, economics stands revealed as a study of rubber bands, albeit rubber bands that drive economic activity, but rubber bands nonetheless.

Another voice has been added to the hue and cry for a minimum price for alcohol. Within days of Rubber Duck stepping down from his CMO post, the better to quack his favourite message, NICE, the National Institute for Health, Clinical and Anything Else Anybody Will Pay Us For Excellence, has jumped on the wagon. Voluminous guidance, published earlier this week, recommends a raft of measures that, NICE says, will ‘significantly decrease alcohol consumption’ if implemented. A top tip for government is to make alcohol ‘less affordable by introducing a minimum price per unit’. There was much talk of growing tides of unassailable evidence. Dr No began to fear he was now King Canute, alone on the beach, his once half full glass now half empty. Until, that is, he heard an interview on the Today programme. Suddenly the glass was half full again.

That smuggest of colleges, the Royal College of Physicians of London, already infamous for its part in the MMC/MTAS disaster, has of late been cozying up ever more closely to the Department of Health, and its chief pongo, Sir Liar Liar Pants on Fire Donaldsong. Earlier this week it moved still closer, issuing an right-on report damning callous smokers who kipper their kids.

The report, featuring a cover photo of a prole caught in the hideous act of kippering a bairn, contains shocking figures and urgent recommendations in bountiful supply. Passive smoking, it estimated, caused children over 300,000 UK GP consultations and almost 10,000 hospital admissions every year, at a cost to the NHS of about £23.3 million. An alarming list of childhood illness caused by passive smoking includes old favourites such as asthma and wheeze (22,000 extra cases) and middle ear disease (120,000 extra cases), as well as the reliable media magnets meningitis (200 extra cases) and cot-death (40 extra deaths).

Dr No’s mother, a fit 80-something year old, recently attended an ophthalmology clinic, on the advice of her optician, and was told – out of the blue, by a nurse – she hadn’t even seen a doctor - that a bed had been arranged for her to come in two days later to have her cataract removed. The nurse was most put out when Dr No’s mother – who knows her mind very well – said she had no intention of coming in for an operation she neither knew about, nor did she need. Yes, she does wear reading glasses – but otherwise her eyesight is fine.

It is a truism of the festive season that, as the party lights come out, so to do the Temperance Brigade. Last week we had two pronouncements: one from Sir Liar, advising no booze for under fifteen year olds, and another from Alcohol Concern, telling us we grossly underestimate our consumption when answering drink surveys. What Alcohol Concern didn’t say – probably because they hadn’t realised it – is that the study data behind their pronouncements show that the current safe drinking limits of 21 units/week for men and 14 for women – already known to be arbitrary – are also misleadingly low.

The planet may be heading for Gas Mark 10 – and the country half buried under snow – but that is not the only science anomaly in the news.

Yesterday, we had Pants telling us that not a drop of the demon drink should pass the lips of children. Where once we had Gin Lane, we now have middle class parents weaning tiny tots into blotto tots. Pants even managed to tot up some figures of his own: half a million of England’s 11-15 years olds had been drunk in the last four weeks, he wailed, before switching to Full Temperance Mode: childhood was being robbed of its ‘clear-eyed innocence’, only to be replaced with the ‘befuddled futility’ of ‘dirt cheap alcohol’.