No More Turning Away - Like Kindness, Public Health Matters, Always

Last week left me struggling to describe the collective experience we witnessed as events unfolded at Westminster. I felt my descriptive lexicon was totally exhausted. Mayhem, havoc, chaotic, humiliating, confusion, toxic and very, very sad. These are all the words that come to mind when I think about the last few weeks in UK politics. My sadness is for the country and what has been done to our way of life.  I've also felt increasingly sad for Liz Truss’s husband, Hugh.

As sometimes happens, when I look at individuals for background information for my blogs, I am often surprised by the connections with my world. Hugh O’Leary’s mother was a nurse, and his father was a lecturer. He went to the London School of Economics, where he met Therese Coffey, our current Secretary of State for Health and Social Care (SoS).

I cannot begin to imagine the stress the pair of them have been under. Standing by his wife, which he has done on a previous occasion, but in different circumstances, would have been incredibly difficult. I take my hat off to him. His dignified and solid support for Liz is to be applauded. However, to be clear, I’m appalled by the damage she has wrought on the UK during her brief time as Prime Minister. As someone said last week, what has happened is unforgivable and we should never forget this time.

Equally appalling last week, was the news that Therese Coffey had recently admitted that she had illegally shared her own supply of prescription medications with friends and family. The UK Medicines and Healthcare Products Regulatory Authority confirm that it is illegal to share prescription medication with someone for whom it is not intended. She was rightly taken to task by folk on social media who described her as Dr Feelgood, with a handbag full of illicit goodies – not a good place for a minister of state to find themselves.

Her behaviour was wrong on so many levels. As are her plans to allow pharmacists to dispense antibiotics without the need of a GP prescription in order to reduce demands on GP practices. Her proposal was condemned by many health care professionals. Professor Stephen Baker, a Cambridge University international expert in molecular microbiology and anti-microbial resistance, described the proposals as ‘moronic’. He added that widening access to drugs in this way was dangerous. The overuse of antibiotics contributes to the emergence of drug resistant bacteria, and reducing the unnecessary prescribing of antibiotics has long been a central plank of UK public health policy.

In any event, pharmacists can already prescribe and dispense prescription-only medicines in some limited emergency circumstances. Likewise, other pharmacists who have undertaken further training, can practice as a pharmacist independent prescriber. Like doctors and Advanced Nurse Practitioners, with prescribing rights, they are able to prescribe medication for any condition they’re clinically competent in. Actually, both have been able to do this since 2006, when Patricia Hewitt was SoS for Health. The approach was introduced as a way of reducing pressure on GP practices. I have used this service when my repeat prescription medication is up for review, and my pharmacists has always been able to independently change my medication as necessary. I have always felt to be in safe hands.

And whilst I don’t want to be accused of hounding Dr Feelgood, her ultra-libertarian ideology doesn’t make me feel that the UK’s health care system, or me personally, is in safe hands. My favourite philosopher, Michel Foucault, when talking about the relationship between the State and healthcare argued that a doctor’s first task, before seeing the patient, and providing a diagnosis and treatment, is a political one. He suggested that doctors must first ‘begin with a war against bad government’. So, I make no apologies for speaking truth to power in my criticism of the proposed changes to current UK health care policy. I’m not the only one either.

You may well have seen Dr Dan Poulter’s stinging challenge last week, where he described Dr Feelgood’s hostility to what has often been referred to as the ‘nanny state’. Dr Poulter is well qualified to challenge the Dr Feelgood approach. He is a Conservative MP, an NHS doctor and someone who served as health minister in the coalition government (2021-2015). It seems Dr Poulter’s motivation for calling out the SoS was her opposition to banning adults from smoking in cars containing children – even though this practice was made illegal in 2015. Dr Feelgood is a smoker and has long opposed any restrictions on smoking. Making it clear that she wants to scrap previous measures to curb obesity such as the sugar tax, not introducing the smoking control plan, and ditching the health inequalities’ White Paper feels very short-sighted and, frankly, alarming.  

More smoking and greater rates of obesity will result in more chronic ill-health and increased pressure on the NHS. It is also likely to result in reduced life expectancy for many, particularly amongst the poorest groups in our communities. It seems to me that our current SoS is choosing to ignore what I think is both an ethical and practical responsibility of any government to tackle those known contributors to poor health. Individuals have a responsibility for their own health for sure, but so does our government. Foucault also observed that the impossibility of perfect health implies the impossibility of a perfect health care system. Choices will always have to be made as to what is practically and economically possible to provide in terms of health care. Ditching the UK’s evidence-based public health policy doesn’t seem to be a great choice.

I live in hope, however. We are clearly going to have a new Prime Minister by this time next week. Hopefully this will mean a new Cabinet too. If we don’t, the mayhem will continue and again, it will be you and I that stand to lose out once more. Given next weekend will be full of excited children embracing Halloween, let’s hope there will be more treats than tricks this time round.