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‘Perhaps people think cure is better than prevention’

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Eat, drink and be merry, for tomorrow we discover that the antibiotics for bacterial infections may no longer effect a cure

Eat, drink and be merry, for tomorrow we discover that the antibiotics for bacterial infections may no longer effect a cure.

The cause may not be the emergence of more resistant strains of bacteria. It seems far more likely to be because we’ll all end up sedentary and obese, and will therefore have developed embarrassing tendencies to sit down heavily on packs of penicillin, squashing them into therapeutic oblivion.

After years of belief in health promotion as a worthwhile concept, I am starting to ask myself whether it is time the public was threatened with the naughty step. Why? Just look at the reams of directives and reports on healthy living that have come our way. Even when they seem contradictory, they are always well intentioned.

We provide accessible leaflets. We start local initiatives, for example slicing kiwi fruit for nursery school kids who can’t identify an apple and who think that crisps form part of their ‘five-a-day’ intake of fruit and veg. We leap in with funds for deprived areas. We even intimate that living healthy lives is our duty as good citizens which, incidentally, happened to be an approach promoted with great gusto in 1930s Nazi Germany.

And what happens? The nanny state’s health promotion specialists become either figures of fun or are perceived as arch villains. So, with 2008 soon to appear, I feel it is an opportune moment to shake things up and turn health promotion on its head.

I intend to open a counter-intuitive unit for health promotion, with a mission statement to stop health promotion forthwith. I have decided exactly how it will be organised.

As from 2 January, when the gyms reopen, I shall close them down and surround them with barbed wire so no-one can gain access. I will ban the production and distribution of any health promotion materials concerned with lifestyle. Health trainers will either be deported or offered jobs selling doughnuts. In nursery schools, children will be taught happy songs about hydrogenated fats. Fresh vegetables will be furtively exchanged in dark alleys. People caught on CCTV walking briskly will be at risk of appearing on Crimewatch, unless they are carrying a can of beer. Smoking will be enjoyed in pubs, theatres and restaurants. Illness will be treated – it just won’t be prevented.

I will then stand back and wait for the inevitable adverse epidemiological consequences. I will listen to the howls of outrage from people who want to disband my unit and replace it with exactly what we have now – health promoters who want to help groups and individuals to access and adopt lifestyle choices that might increase their well-being. Or perhaps people really believe cure is better than prevention?

Jane Warner is a practice nurse in Devon

NEXT WEEK: Linda Nazarko on proposals to reconfigure GP services in London

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