Making ‘health’ healthier in 5 painful shifts

Shift #1

Health is a political issue. If we are to see global health improvement, then we need to shift the conversation from ‘medical problems’ to ‘political’ and ‘communal’ issues.

We can’t therefore meaningfully speak about health improvement without also speaking about environmental, democratic, and economic improvements.

Shift #2

Action towards health improvement must lead away from an almost total dependency on professional interventions and tools, toward community-building and citizen action. 

Health is not a product of health systems but of humanness interacting with itself, its environment and its economy.

Shift #3

As community building as a tool for health improvement gathers momentum, the medical system should lead by stepping back…but will it?

Like all systems, the medical system must consider the harm it does in expecting people to organise themselves and their ailments the way the system organises itself.The medical hegemony often inoculates itself against again solving the problems it was set up to solve.

Shift #4

Mobilising to grow healthfulness in our communities will demand some level of relinquishment by the medical system of the resources and ground it currently claims for therapeutic purposes. 

Resources need to flow towards the domain of greatest health producing competence: citizens organised in communities. In essence, this means that even if a small portion of medical system budgets were reinvested in community building and away from medical intervention, huge savings should result and significant harm to social capital averted.

Shift #5

Health is not something we bring to people; it is the net result of a community coming together to use what it has to secure what it needs, including medical systems when required.

Cura te ipsum (Physician, heal thy self!)

Cormac Russell

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  • I’m currently working on updating an article with a lot of specific suggestions on exactly this. The above eloquently articulates the overall picture – and I will be glad to look at the related articles too.

    September 9, 2015 at 2:48 pm
    • I’d very interested in reading you article when it is ready. BW Cormac

      September 10, 2015 at 3:34 pm
  • Also this is very reminiscent of what the Pioneer Health Centre, otherwise known as the Peckham Experiment, was demonstrating in 1935 – 1950.

    I recommend also this paper by David Godway: This brings out the importance of autonomy and self organisation in human health. One can see in the Peckham Experiment the principles of effective community facilitation.

    This year is the 80th anniversary of the experiment which was decades ahead of its time. We are celebrating the anniversary by a gathering in Peckham of the widely scattered Pioneer Health Foundation trustees and some former members, with a few local people who have helped to keep the candle of light from those days flickering in Peckham and more widely.

    September 9, 2015 at 10:32 pm
    • Thank you so much for sharing these links and highlighting the connecting of what I’m saying in theory to a living moment in history where Pioneering people made these aspiration real and vibrantly visible. I look forward to connecting soon. BW Cormac

      September 10, 2015 at 3:37 pm
    • As a teenager in the 70’s I was occasionally mysteriously drawn to walk past the site (a school as it was then) on a seriously ‘out of the way’ route home from my own school, and could feel a strange energy remaining there – though I knew absolutely nothing of the project until accidentally stumbling across references to it in a library 20 years later!

      I also recently found out that a friend in Abbey Wood went there as a child.

      I have long agonized over why it was overlooked as the model for the NHS – such a tragic mistake if ever there was one. Now 60 plus years later we are finding out that the “disease-model” is an “insatiable giant” that threatens to engulf us. I was at a GP Patient Participation Group meeting today being told about demands for trivial (but still expensive) “corrective” cosmetic surgery (for slight body asymmetries, etc) to be provided on the NHS, for example, on top of the ever increasing patient numbers and chronic ill-health levels.

      From my reading, the Peckham Experiment seemed to me to be built on the principle of the ‘whole family unit’ – something which has gone under extremely severe attack in the generations since. Consequently as adults (and even children) we are now treated as individualised autonomous units, invariably entirely without reference to anyone else in the family.

      That family “egg” is now very widely well and truly “scrambled”, and often extremely insecure where it does exist – but to my mind, until we do recover some kind of secure family structure…something communal, incorporating the various types of family that are left, rather than the strictly biological one, perhaps – it will be difficult to make much headway in terms of true health promotion within the community.

      The Peckham Experiment was totally visionary – but still necessarily something of a ‘top-down’ initiative (although I’m certain with huge amounts of democratic features) which it seems unlikely to be able to repeat in the same way. If its legacy could, however – after-all, inspire some ‘bottom-up’ thinking – then there is the possibility that the flickering flames could yet re-ignite into something spectacular.

      September 11, 2015 at 9:36 pm

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