The future of ‘public health’
Friday, April 10, 2020 at 12:04 
I was an interested observer of an IEA webinar yesterday.
Hosted by director-general Mark Littlewood wearing a fetching pair of headphones that subsequently stopped working and had to be replaced, the hour-long event featured a 30-minute talk by Chris Snowdon (above) followed by some Q&As.
The subject was ‘What’s the future of public health post COVID-19?’
It was a private event so I won’t go into detail because I believe Chris’s contribution will be posted online when you can see and hear it for yourself.
I was going to ask the question ‘How do you define ‘public health’?’ but Chris sort of answered that during his talk.
If I can repeat one thing he said, he took the view that ‘public health’ should be responsible for just two things - environmental pollution and contagious diseases.
I agree with that, I think. The problem is, that’s not how the public health industry sees its current role.
Ever since the scourge of tuberculosis, measles, chicken pox, diphtheria and so on were addressed and either eradicated or substantially controlled in the West, the meaning of ‘public health’ has evolved dramatically.
Today, if you Google ‘What is the meaning of public health?’, you are directed to this definition, courtesy of the World Health Organisation:
Public Health is defined as “the art and science of preventing disease, prolonging life and promoting health through the organized efforts of society” (Acheson, 1988; WHO) ... Public health focuses on the entire spectrum of health and wellbeing, not only the eradication of particular diseases.
As you can see that covers just about everything and gives carte blanche to organisations like WHO and Public Health England to interfere in just about every aspect of our behaviour if it helps prolong our lives for a few more years.
Therefore, in a post COVID-19 world, we must have a serious debate about what is meant by ‘public health’. In particular we need to try and redefine it in terms that do not allow ‘public health’ bodies like WHO and PHE to dictate our lifestyles to the extent they would like.
A big worry is that, on the pretext of ‘protecting’ the public against future pandemics, governments will give public health organisations even greater powers to restrict and change our behaviours.
We’ve all seen what happens when you give the police extra powers or ‘guidelines’. A handful go too far. Drones in the Peak District, officers patrolling parks and beaches, moving on solitary couples ...
This morning Cambridgeshire Police tweeted:
Officers visited Tesco Barhill this morning as part of their patrols around supermarkets and green spaces this weekend. Good to see everyone was abiding by social distancing measures and the non essential aisles were empty.
The tweet was subsequently deleted but it interested me because Tesco Bar Hill is between my home and the Forest office in Cambridge.
I rarely go there (Tesco Bar Hill not the Forest office!) but I’m not sure how I would react if a police officer started rooting through my shopping for ‘unessential’ items.
Wine, beer and hot cross buns may not be essential but that’s subjective, surely? Ditto ice (for my evening G&T), Ben & Jerry’s Phish Food chocolate ice-cream, and a case of Diet Coke, all of which I purchased from Waitrose on my weekly shopping trip yesterday.
If such things are on sale in a supermarket or convenience store, why in hell’s name shouldn’t we be allowed to buy them?
As long as it doesn’t involve numerous trips to multiple shops (which it didn’t), what’s the problem?
Imagine, though, if Public Health England was to propose, post COVID-19, new shopping guidelines for the ‘benefit’ of our health.
We already know that from May 20 menthol cigarettes - which account for 25 per cent of the UK cigarette market - are going to be prohibited.
It’s not a huge leap to envisage a day when more products will be banned or severely restricted as ‘not essential to a healthy lifestyle’.
The threat to tobacco and alcohol is obvious. The South African government has already prohibited the sale of both as ‘non-essential’ during the current public health crisis.
Namibia (or Malawi, I can’t remember which) has followed suit. There are suggestions Kenya may do likewise, although a report I read yesterday said tobacco and alcohol are on the Kenyan government’s list of essential items.
A week ago there were even reports that the Mayor of New York intended to ban the sale of tobacco but that was quickly rebutted by his spokesman.
I suspect that over the next few months the tobacco control industry will fly a lot more kites like that to gauge public support for similar prohibitionist policies.
There is a very real danger that if we don’t nip this in the bud, calls to further restrict or ban the sale of tobacco will get louder and more frequent.
Meanwhile, when they’re not spreading alarming and sometimes misleading messages about the increased threat of coronavirus to those who smoke or vape, public health campaigners are mostly content to urge governments to use COVID-19 as an opportunity to press home the quit smoking message.
But that’s another story to which I’ll return.
Reader Comments (4)
I guess those forced into suicide by these joylss control freaks will be deemed collateral damage.
Public health is out of control and the public needs protection from it.
I agree Pat, for those on total lockdown, I cannot even imagine their despair. No way smokes will be deemed essential or alcohol. You vill be forced to give up and comply. Very hard to bare what is going on.
There is no future for "public health".
Hancock is why I will never lend the Tory party my vote again and I hope that whatever is left of the Brexit party can regroup, rename, and become as avidly anti nanny/bully state as it was about the EU. This country and its voters are crying out for such a party to free us from the snobs, and the hypocrites.
No one voted Tory to get Deborah Arnott making decisions in health nor did we vote for Hancock to promote fear and hatred of smoking with regard to covid 19 when there is no evidence to support it. This government is as dishonest as every other infiltrated by smokerphobics over the last 13 years or more.
It talks equality and inclusion and then launches exclusion and discrimination at one group of people singled out for the purpose.
Sadly, the likes of pocket politicians Hancock fail to see the hypocrisy.