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Pills won't cure ills caused by poverty

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VOL: 97, ISSUE: 41, PAGE NO: 29

Tracy McFall, BSc, RGN, OHN

There are many times on the wards or in the community that I've been disillusioned by the care patients receive. I have frequently been asked to give care without any knowledge of a person's circumstances - whether they are living on the poverty line, whether their house is damp or whether they have any relatives or friends who can help with the shopping or the kids.

There are many times on the wards or in the community that I've been disillusioned by the care patients receive. I have frequently been asked to give care without any knowledge of a person's circumstances - whether they are living on the poverty line, whether their house is damp or whether they have any relatives or friends who can help with the shopping or the kids.

The panacea for all NHS ills is to put more nurses, doctors and money into primary and secondary health interventions. While these may be much-needed resources, they are stuck in a traditional model of health promotion.

For example, I have a friend who lives in a deprived area of Glasgow and who has a young son with asthma. Mother and son live in a damp, high-rise flat with no central heating. They rely instead on an electric heater, which generates very little heat for most of the year. The mother is depressed and smokes incessantly.

The smoking and damp ensure that both she and her son have frequent upper respiratory infections and the son experiences regular exacerbations of his asthma. Gently, I've told her that she should give up smoking, or at least try to smoke in only one room.

They are both well known to their local health practitioners. Both are treated regularly with antibiotics, her son has inhalers for his asthma and she has antidepressants and counselling for her depression and alcohol misuse. I'm sure the GP and practice nurse despair of them. Hopefully, they are humane and can see beyond the person in the waiting room.

Many medical and nursing interventions act only as a sticking plaster for the real problems: poor housing; unemployment; isolation; lack of community and family 'connectedness'; lack of hope.

I believe that a warm home with a bit of extra money and an occasional holiday could do more to help the physical and mental health of people like my friend than any medical or nursing intervention.

Money is being poured into national health promotion programmes while the government is cutting more and more money from local authority budgets. Much of this is being done in direct response to what the public, nurses and doctors have ordered.

People need nurses and doctors, but the public and politicians must realise that doctors and nurses do not have a monopoly on keeping the nation healthy.

Yes, resources are desperately needed in NHS hospitals and in the community but resources are also needed elsewhere - in housing developments, well-resourced libraries and cheap access to sports facilities, which also play a valuable part in keeping people healthy.

This country's poverty and poor health must be tackled at its root causes. By pumping money into the NHS on an ad hoc basis, we are only striking at the branches - to the detriment of the whole tree.

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