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Do as nanny says

Phil is deeply insulted by a poster that’s recently appeared in the staff toilet

Phil is deeply insulted by a poster that's recently appeared in the staff toilet

The words fill me with fury. It is possible that there are five more irritating words in the English language, but for the moment I cannot imagine what they are.

I see those words every time I go into the staff toilet in my practice. They are on an assertive blue poster pinned above the washbasin, bullying me into the most effective sequence of activities to clear my hands of pathogens. What a profound educational experience.

I notice it is laminated, presumably to preserve itself against some whirling dervish of an excreting GP who has not yet grasped that effluent should go down the bog, and who sprays it round the cubicle instead.

In full, the poster reads: ‘Wet Soap Wash Rinse Dry. Stop germs spreading. Have you washed your germs away? The power is in your hands.'

Well, so it is. I've been a doctor for 20 years, and I've been familiar with the idea of hygiene for perhaps 40 years. Who could argue with the basic concept? Our man Lister introduced the theory in 1867, and no-one since has found any evidence to refute it. Since I learned the reason why, I've always automatically washed my hands. Until now.

I don't like to be condescended to. I never had an urge to smoke a cigarette until I was forced by legislation not to, and I don't want some didactic poster berating me to do the bleeding obvious with the soap. Roughly wiping the MRSA from our hands onto our white coats, we are supposed to pause long enough during our comfort breaks to gaze at this sage advice. ‘Bugger' we are supposed to think. ‘I wet rinsed dried but forgot to soap wash'.

Paternalistic edicts

The ‘Wet Soap Wash Rinse Dry' poster is distributed free by the Department of Health to every dirty shitty-handed germ-laden doctor in the country. It is by no means published in isolation. I was moved to visit the Department of Health website and check out what other advice they might be offering the profession and the nation.

You could not accuse them of being idle. The website is a cornucopia of cod-research, unasked-for advice and paternalistic edicts. Publications are tumbling over each other in their haste to be laid before the public, dozens every week. There were 18 of them in just this last week. Still, what a heady glance at public health information it proved to be.

The last three days provided the following. ‘Uniform and work wear; an evidence base for developing local policy'. ‘A guide to healthy fasting during Ramadan'. ‘Reducing health inequalities for lesbian, gay, bisexual and trans people'. ‘The further evaluation of the school fruit and vegetable scheme'.

Remarkable stuff, and obviously the hard-earned fruits of the labour of some obscure tribe of publicly funded civil servants. Check it out. Ponder on how essential this stuff is. Almost none of you, the people who actually deliver 90% of the healthcare to the population of this country, will have been aware of even a tiny fraction of it, and an even smaller proportion of you would benefit from this tidal wave of disconnected, obscure information.

Is this a reasonable use of public funds and NHS resources? I step aside and leave this question to your personal judgment (with a tiny caveat of my own that suggests, No it bloody well isn't).

Now wash your hands.

Dr Phil Peverley is a GP in Sunderland and PPA Columnist of the Year 2006

Peverley The offending poster The offending poster

'What a profound educational experience'

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