Self-care

Abstract

Over the past couple of decades, two different views of health care have been adopted by the theorists. The first, and perhaps the commonest, held by medical and non-medical people alike, is to equate health with the absence of sickness and therefore to see it as a product of medical care. There is a powerful infrastructure bolstering this concept. First, undergraduate medical education extols the virtues of technological medicine at the expense of community care, in terms of curricular time and influence. Second, we are concerned largely with the hospitals as centres of care and spend 70% of our NHS budget developing them. Third, powerful commercial interests, such as the drug industry and the surgical instrument industry, tend to preserve the status quo. Fourth, media coverage glamorizes high technology medicine: ratings are higher for heart transplants than for a routine visit by a health visitor. Finally, the development of private medicine, which not unnaturally focusses on high revenue surgery, tends to confirm the view that health is essentially a process of symptom swatting.