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‘Nudging’? Try ‘nudging’ a twenty-stone fag-toting diabetic…

Copperfield is somewhat underwhelmed by the Department of Health's latest Big Idea on public health

I've tried to read the public health white paper. I have. Really. It's just that…you know…OK, I haven't really. But I have read the summary. No, honestly, I really, really have. Well, OK, I haven't. But I have read the summaries of the summary. At least I tried to. Read the soundbites, that is. Or, at least, the headlines. Or....zzzzz.

OK. I didn't. Because every time I tried to digest the public health white paper I was reminded that sleep apnoea isn't all bad.

I have, though, managed to retain three facts. First, that my reluctant evolution into a default public health doctor continues apace, as 15% of QOF payments are to be tied to public health targets.

Second that, apparently, we've moved on from the nanny-state approach to a more mature strategy of 'nudging' people into healthy lifestyles - fine, except that if you nudge a twenty-stone fag-toting diabetic behemoth you tend to elicit very little movement indeed. Besides, this concept of ‘nudging' rather undermines my favoured health promotion approach, which isn't so much to ‘nudge' patients as to bludgeon them about the head with a baseball bat.

And third? That representatives from GP consortia will have to sit on new ‘local wellbeing boards', and GP consortia will also have an 'explicit obligation' to prepare ‘Joint Strategic Needs Assessments' and local communities will be empowered to ‘challenge GPs to enhance their performance' in giving public health advice and… blimey, it's warm in here, isn't it… yawn… Nudge me if I drop off.

Actually, don't.

'Sick Notes' by Dr Tony Copperfield is out now, available from Monday Books.

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