Diagnosis: Nagging

Posted on: 10 January 2012 by Alexander Hay

Plans to make NHS staff quiz patients about their lifestyles reflect a patronising, self-defeating arrogance not just on the part of politicians, but the medical profession itself

How long will we continue to trust our doctors when they start intruding into our personal lives?Politicians are inherently in search of something to do. By their very nature, a class of people whose job it is to run the country are going to find it hard not to intervene somewhere, somehow... For our own good of course.

Labour has a long and inglorious history of this, but it seems the Conservatives are now catching up with the relentless nannying:

Ministers are pressing ahead with proposals that will see NHS staff ask patients about their lifestyles during appointments, despite concerns that patients may resent such "intrusive" questioning.

The health secretary, Andrew Lansley, has decided to back the NHS Future Forum's controversial idea, which calls on midwives, surgeons and health visitors, as well as doctors and nurses, to ask patients about their smoking, drinking, diet and physical activity every time they see them...

Needless to say, this is a bad idea. Apart from alienating patients, it also places health professionals in a quasi-policing role, where unhealthy/deviant behaviour is sought out and the guilty parties harassed. Or to put it another way:

...The Royal College of Nursing voiced doubts about the potential impact on relationships between NHS staff and patients, some of whom might be embarrassed by such questions or not tell the truth...

If policing by consent has long since gone the way of the Special Patrol Group, then at the very least, public health care must retain some degree of discretion. Badgering your patient is simply going to make them less and less willing to come back or even trust you. No one likes being told off or probed - and yet the government seems hellbent on making us all like 15 year olds living with overprotective parents.

But what is more worrying is that the idea comes from the medical establishment itself:

...The forum is a group of 57 experts chaired by the government's NHS trouble-shooter, Prof Steve Field, former chairman of the Royal College of GPs. Its report says: "There are millions of opportunities every day for the NHS to help to improve people's health and wellbeing and reduce health inequalities, but to take this opportunity it needs a different view of how to use its contacts with the public...

..."A routine dental checkup or eye test, for example, is a chance to offer advice to help someone stop smoking. A visit from a midwife or health visitor is an opportunity to talk about a new parent's anxieties and consider options for accessing mental health support. Collecting medication from a pharmacy is a chance to offer someone help with cutting down on alcohol. A pre-surgery checkup is an opportunity to talk over concerns about smoking, diet and physical activity..."

Or a great way to alienate your patients and make them less likely to cooperate with you. This hectoring, high handed manner has become something of a bad habit amongst doctors of late, lauded as they are as the most respected and trusted of professions. How long that good image will last is debatable, however, especially if they stop being doctors in the usual sense and turn into the medical equivalent of dinner ladies ordering you in because it looks like it might rain.

Ultimately, you can only help people insofar as they wish to be helped. Forcing the issue will not work. Rather than winning the argument for better health, however, it seems the medical profession would much much rather harangue us into wellbeing. For our own good, you understand.

[SOURCE: The Guardian]

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Alexander Hay

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