| | Rob Lyons
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Stop smoking or your children will die
The redefinition of smoking in cars as ‘child abuse’ is about guilt-tripping parents into changing their behaviour. |
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Last week, Dr Steve Field, chair of the Royal College of General Practitioners (RCGP), was in the news for endorsing the idea that overweight people should be told that they are ‘fat’ to encourage them to do something about their weight. In Sunday’s edition of the Observer, he continued his attack on people who have the ‘wrong’ lifestyles in a piece arguing that smoking in the home or the family car should be recognised as a form of child abuse. For Field, it seems that emotional blackmail and dubious medical claims are all valid tactics in the pursuit of making patients – and especially parents – do The Right Thing.
 Field says he approves of the tone of the new Lib-Con government’s health policy. He sees the move from nannying the public to encouraging them to take personal responsibility as a welcome shift: ‘In the space of three months, the thrust of public health policy has shifted towards a desire for individuals to take more personal responsibility for their health and the health of their children. It is a dramatic change in emphasis from the last government, sometimes accused of wanting to remove all our personal freedoms and make big decisions for us.’ He continues: ‘The truth is that too many of us neglect our health and this is leading to increasing levels of illness and early death.’
This seems a rather strange assessment, given that life expectancies continue to rise steadily. In fact, the Lib-Con government is now fiddling with pension arrangements and retirement ages in an effort, we are told, to stop the ever-increasing number of older people from bankrupting the nation. How does that fit with ‘increasing levels’ of early death? Field clearly sees himself as a straight-talking kind of guy. Unfortunately, he’s not so much talking straight as talking fearmongering nonsense.
Field’s piece in the Observer, which has hit the headlines in other papers subsequently, takes aim at parents in particular. ‘I believe that parents who smoke in cars carrying small children are committing a form of child abuse’, he says. This kind of melodramatic exaggeration might be suitable for a stroppy teenager, but it is laughable from the head of a high-profile medical body. Not so long ago, children could be expected to make immediately for the top deck of the bus to and from school, where they would sit in the fug of smoke produced by their schoolmates, other commuters and themselves. Yet somehow these children survived. Now, a high-profile doctor fills newspaper column inches by comparing a whiff of smoke from a parent’s cigarette with child abuse. All sense of proportion and perspective has gone out of the window.
However, Field is only getting into his hysterical stride: ‘Parents need to act as role models from early on and take control of their children’s eating habits by providing sensible, appropriate portion sizes and by not feeding them rubbish… Unless parents exert more control over their children’s diets, they are risking a lifetime of health problems and even premature death – death before their parents, which is almost too sad to contemplate.’
More to the point, it is too rare to bother contemplating.
Children dying before their parents remains very, very unusual. A report published in the Lancet in March 2009 suggested severe obesity – which affects only about two per cent of the UK population – could knock 10 years off life expectancy on average. So even in this case, it would still be unusual for even the very overweight – never mind the majority of much lighter people who also qualify as ‘obese’ – to die before parents who are 20, 30 or even 40 years older than them.
Given Field’s tone, it would be easy to conclude that the country is being swept by a tsunami of premature death. A quick reality check is in order. In 2008, excluding newborns, there were just over 2,000 deaths among children under 16 in England and Wales out of, very roughly, 11million children. So the most obvious point to make is just how remarkably little chance there is of a child dying, full stop. Childhood mortality, once commonplace, is now extremely rare. Looking at the broader picture, the UK Office for National Statistics recently announced that mortality rates for the population as a whole have never been lower.
Yet according to Dr Field, it is at this moment that we need to turn the screws on parents to be more responsible. Field may claim to want a different style of government intervention – with a greater emphasis on nudging us towards the approved lifestyle rather than endless hectoring and regulation – but his Observer article shows that there is no sign of the moral blackmail coming to an end just yet.
For example, he clearly believes that if parents won’t stop smoking for their own sake then they should be browbeaten into doing it for the sake of the children. In March this year, Field said: ‘Parents wouldn’t intentionally let children breathe car fumes or carbon monoxide, yet passive smoke exposure is affecting the lives of around two million children in households in the UK. We must take urgent action to stop children’s lives and their health being blighted.’
Field is another in a long line of (almost) self-appointed guardians of the nation’s health who feel free to demand that we conform to their vision of appropriate behaviour. Sunday’s Observer referred to Field as ‘Britain’s top GP’ (almost as if there were some kind of medical profession league table) while BBC News suggested that he ‘represents 42,000 GPs across the UK’. In fact, Field was elected by a few dozen members of the RCGP’s governing council, elections for which seem to attract a derisory turnout. It is on this basis that he gets a platform for his tendentious views.
Enough already. While there is a lot of talk about finding the appropriate balance between personal responsibility and state intervention, there is very little discussion of personal autonomy. We do not need busybodies like Field telling us how to live our lives. Even knowing the risks of certain habits - like smoking or drinking - we may carry on because we simply enjoy doing these things. That should be our choice. Instead of pontificating from the pages of the Observer, Field would do far better to treat his patients – actual sick people who could benefit from his years of medical training and experience – rather than stirring up misplaced panics about our health.
Rob Lyons is deputy editor of spiked and blogs about food at Panic on a Plate.
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