We have more information about staying healthy than any generation before us. We know it is unhealthy to smoke, to work in buildings lined with asbestos or to eat big tins of biscuits.
What’s more, we receive new health advice every week. Last week, for example, we learnt that drinking very hot tea can lead to oesophageal cancer while staying on at school a little longer - until, say, 35 - may decrease the risk of dementia.
The logic of health education is clear: if we are given lots of information that helps us to make healthy choices, it will reduce our risk of getting a disease. Working in health care, we know this is important because the Wanless Report on long-term health trends told us that if we didn’t address health prevention the health service would be unaffordable by about 2020 or - given the current economic climate - this Thursday.
Recently, a mass programme of health checks for over-40s was launched in England. Government ministers say it will save 650 lives a year (you can’t help wondering where that number was plucked from, can you?). They plan to target those people who have somehow avoided the present array of health-check opportunities, no doubt hoping to lure the lard-eating, beer-guzzling biscuit-eaters out from behind the bushes so they can embrace the modern health service and start training for the Great North Run.
‘They are hoping to lure the lard-eating, beer-guzzling biscuit-eaters from behind the bushes so they can start training fore the Great North Run’
But who is convinced? The BMA isn’t. The president of the Faculty of Public Health isn’t. As a nurse said to me recently: ‘Helping people to know things is not the same as helping them to meaningfully care about them.’
To have a real impact on public health we need to address the relationship people have with their own health and well-being. That appears to be hard. When working as a health promotion nurse, I was once told that I was wasting my time talking about health and well-being because people had the ‘right’ to do whatever they wanted. The individual went on to say that if it wasn’t for people like him the health service would collapse because of the tax they paid on beer and cigarettes. ‘If I get ill,’ he said, ‘you can rest assured I’d have earned the care I receive.’ Which made me wonder if some sort of ‘stupid levy’ might be an idea for future health-service funding…
If we can’t address the relationships that individuals have with their health, perhaps we need to address their relationships with the institutions that serve them, particularly the health service. It seems sometimes that we are so preoccupied with our rights as expressions of our personal liberty, that we forget to consider our responsibilities - not only toward ourselves and those closest to us but also towards the collective well-being, as serviced by a breaking health service.
Maybe the question isn’t simply: ‘How are we going to use the health service to save people from themselves?’ but, rather: ‘How, ultimately, are we going to save the health service from those people who don’t care enough about it to consider it a precious resource?’ I suspect we aren’t.