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Gold, incentives and meh

Fuming at the quitters

Phil's got very little time for smokers who won't accept responsibility for their own actions

Phil's got very little time for smokers who won't accept responsibility for their own actions

Because I care about my patients and, on the whole, respect them, my approach to them is relatively straightforward. I don't condescend. These are grown men and women, not children (apart from the children), and I apply the same high standards to them as I apply to myself. They are responsible for their own actions and I expect them to take the consequences of their own actions.

I think I am in a minority here. I cannot escape the fact that I am part of 'the establishment', and it appears that those in a position of power, in particular politicians, are increasingly regarding the general public as lesser beings who are unable to make their own choices; hapless victims of circumstance.

Our present Government appears to think the population of this country is made up of helpless infants. They constantly and increasingly interfere with the most basic of human activities; they dictate how much salt we should consume, where and when we should or should not smoke tobacco, how fat we should be, whether we should be able to smack our children, even what weights and measures we should be allowed to use in selling products to one another.

However, our Government has completely failed to recognise a basic problem in human nature. If you constantly treat people as if they are children, you will make children out of them. If you remove personal responsibility from the equation and take it on to the state, then you make victims.

Take tobacco as just one example. We've had smokers in this country for 400 years, millions of them. The vast majority have given up by now, one way or the other. Everyone gives up, eventually. Smoking is a personal lifestyle choice, and so is stopping smoking.

However, over the past decade, there has been a seismic shift in moral terms. The NHS, not the smoker, is now responsible. You can feel the enormous sigh of relief as the smoker shifts the burden of his habit from his own shoulders on to ours. I see the result of this dodging of responsibility in my surgery every day.

'I need some more of those patches, doctor,' says the patient.

'How so?' I reply. 'You've had two courses already. They didn't help you stop then, so why should they now?'

'But you don't understand. I need them. I have to give up smoking.'

There's no suggestion in his manner that he could give up without state help, despite the fact that millions of people have done exactly that in the past.

He can only give up now if the state funds it, because that's the rubbish he's been indoctrinated with. He thinks he needs counselling and clinics and patches and star charts and all the paraphernalia of childish indulgence and transferred responsibility. Make me give up smoking, he is basically saying. It's up to you. And if I fail again, well it's your failure. Nothing to do with me.

I don't buy this garbage. And because I respect him as a responsible adult, I treat him like the grown man that he is. 'No. Not again. It's your body and your life and this time it's up to you. If you want to give up, you'll give up. And if you don't, it's your fault and not mine.'

Dr Phil Peverley is a GP in Sunderland – he is MJA Columnist of the Year

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