The Big Picture of Health

Dr Peter Davies - BSc., MB ChB (Leeds 1989) MRCGP

So, Gordon Brown (UK Finance minister) has announced an extra 1 billion (about $1.5billion) for (UK)
National Health Service spending. This is on top of this years NHS budget of 40 billion.($60 billion)
And he has pledged generous increases in years to come, if necessary paid for by raising taxes.

As a doctor I should be pleased about these increases. I might moan that theyre not enough, or that
theyre too late after decades of under-investment. I should be pleased that more money would mean
more doctors, more nurses, more operations, more scans, more tests, shorter waiting lists, and better
treatments all leading to more health for my patients.

I am not pleased. I am despairing. Not because I dont want extra money or a properly funded illness
treatment service. I am despairing because the debate on health in this country has been reduced to a
battle on NHS Funding. I am despairing because false linkages have been made between an illness
treatment system (the NHS), illness treating professionals (doctors and nurses), and health.

The average doctor has had about 3 hours teaching about health in 5 years study at university. We are
trained to treat illness, and deserve respect for our abilities at this. Our training therefore makes us
ILLNESS professionals, not HEALTH professionals. And health is not just the opposite, or absence, of
illness.

To make matters worse we have a public health concept that says you can measure health by
measuring death rates. In other words if people are not dying they are healthy! Yet all of us have to die
of something and so the death rate is always one hundred per cent. Is it healthier to die of one disease
than another? Cancer or stroke, which would you choose? (Apply here now and as a new NHS service
we can organise this for you!)

How have we reached a situation where experts in diagnosis and treatment of illness have come to be
seen as experts on health? A situation in which every so-called health programme has a tame doctor on
it advising on anything and everything. And even worse the public are apparently lapping this up. Our
media acts to spread bad news and anxiety. The hidden message lies in answering the question Isnt
the world depressing? You really should be worried about this, shouldnt you?

Are doctors particularly healthy themselves? Are they well rounded, well-balanced individuals? If you
were looking for a model of health would you choose a doctor as your example?

You would not, and for good reason. Firstly medicine is a deeply unhealthy profession. (I could explain
why but thats another article!). Secondly doctors spend so long around ill people that we become so
tuned into illness and ill people that we struggle to raise our thinking up to questions of health. One
doctor summarised his role as follows, Our patients spend most of their lives drowning in excrement.
Our job is to direct them to the shallow end.

Health is not the shallow end of a cesspool. The best any doctor can tell you is how to avoid getting ill,
and even at that we are only partially accurate.
Even the language we will use to tell you this information will speak of the determinants of health.
The idea that your health is determined by something else is deeply pernicious as it makes it appear as
if your health is determined by outside forces acting on you. This allows patients to see themselves as
passive victims of disease. It also allows doctors to indulge in rescuer fantasies as they advance to
attack disease. It also discourages patients from looking for ways in which to improve their own
health.

We need to get away from allowing my profession to define the concept of health. We need to choose to
be healthy. We need to do this for ourselves.

Prerequisites for Health

To start with we need to mobilise the prerequisites for health. This is a positive concept and I suggest
the following as appropriate prerequisites for health. (The list is not exhaustive)

Starting at the environmental level we need clean water, clean air and good food. Good food grown in
good soil free from unnecessary fertilisers or pollution. We also need warmth and shelter. Many houses
in this country are in poor condition, cold and under-heated. Is the health service tackling this? No, yet
how do you expect people to be healthy without this?

We need to look at personal and group behaviours and see how we could alter these in such a way as
to generate health.

Moving onto the level of skills and capabilities we need to empower people with the belief that
learning is fun and that we all can learn. Too many of my patients were dim at school and have now
given up on learning. I have to try to demolish their false belief of learned helplessness before I can
give them any concept that they themselves may be able to learn about health improvement. (After all
they learned how to be helpless in the first place, didnt they?) The power I run on is all about my belief
that I can alter my beliefs and so the world. If I did not have this belief I would not even start to write
this article. How can I help my patients to rediscover their own power?

Our beliefs are shaped by our identity, how we see ourselves in relation to others, and more
importantly to ourselves. As a society we, whether deliberately or unconsciously, have multiple ready
to wear dysfunctional beliefs and roles for ourselves and others such as the black sheep of the family
or the victim role.

We need the power to go beyond these false beliefs and stop confusing roles with identity: I work as a
doctor. I am who I am.

To reinforce the power of our individual, and group, identities we need to draw on the power of
spirituality and connectedness. Religion initially meant a process of binding back together and this
connectedness is exactly what spirituality can give. An identity not nourished by a sense of being
connected in to itself or others cannot be healthy. The close verbal connection between salve and
salvation can be re-established.

Too many people in our world can be seen living in a poor environment, pursuing dangerous
behaviours, belittling their abilities, believing lies about themselves, and having a poor sense of who
they are or how they can be connected to others. These people are deeply unhealthy at many levels
and yet to medical science they are normal humdrum people living ordinary lives of quiet desperation.
Medicine does not get involved until diseases arise as a result of the prerequisites of health being
absent. As my colleague Dr Seth Jenkinson says, we deal with end stage social pathology. To
move towards being health workers we need to be involved long before medically recognised diseases
show up.

As individuals, as communities, as a political system we need to establish the prerequisites of health. If

we want more health we need to put the money into ensuring that these are present and not into
treating disease. And we must work at all levels. It is no use providing a good environment if our basic
belief pattern is saying that we do not deserve this. With a belief like this we will simply act in
accordance with it so that the environment will soon be degraded again.

So we must act at all levels. At a political level we must realise that every government department has
the capability to act to improve health. Health is not the sole function of the Department of Health. At a
community level we must celebrate the many things that bind us together and use the common ground
from these to reinforce spirituality and connectedness. At an individual level we must improve our
relationships with ourselves and so with others. The second commandment says, Love your neighbour
as yourself. If you do not love yourself how can you love others? Self-esteem would become one of the
planks of the Health of the Nation plan.

When we love ourselves and others better our behaviour towards others will improve. We will then
enjoy better relationships and this of itself will generate greater health. We will use our beliefs to avoid
damaging our environment in the first place and to mend any existing damage.

We will have enough confidence to accept the occasional illness as part of life. Indeed many people who
have an illness are healthier than those with no apparent illness. We must learn to accept death. (And
maybe only spirituality really lets us do that)

And we will rejoice in our health as a basic part of our lives. And it is so much more than the mere
absence of disease we currently aim for.

Summary Points:

If you need to see a doctor to confirm that you are healthy you are sick indeed!
You can have an illness, and still be healthy.
You may have no illness, and still be unhealthy.
Doctors treat illness and deserve respect for this.
The NHS should be renamed the National Illness Service, for that is what it is.
Full health will emerge when we pay attention to making improvements at all the levels of
health.
The levels are (going down):1

Connectedness/spirituality
Identity
Beliefs
Capabilities
Skills
Behaviour
Environment

As Einstein says, A problem at any level can be resolved provided that it is addressed from a
higher logical level.
When we enable the prerequisites for health to be available at all the levels, then the big picture
of health will inevitably emerge.

1Read Michael Hall's article entitled "How Meta-States Enriches Logical Levels" for a Neuro-Semantics'
explanation of Robert Dilt's Logical Level model which we believe is not really a logical level model but
as Dr Hall states, "It's not a 'logical' levels model, but it's a great model that has many practical uses."
Dr Davies in this article most certainly demonstrates the practicality of Dilt's model.

Author:

Dr Peter Davies
BSc., MB ChB (Leeds 1989) MRCGP
General Medical Practitioner and
NLP Practitioner.
Mixenden Stones Surgery,
Mixenden,
Halifax.
HX2 8RQ

Alisonlea@aol.com

Peter Davies works as a GP in Mixenden, a poor area in Halifax, West Yorkshire,UK. He graduated from
Leeds University (www.leeds.ac.uk) in 1989. He has worked in both hospital and general practice
settings.

He is endlessly fascinated by the ways in which patients and doctors conspire to get poor results when
it would be just as easy to conspire together to get good results. He uses NLP/NS techniques to help
explore this fascination further. He gained his NLP practitioner certificate in December 2001 and should
complete his master practitioner certificate in July 2002.

Acknowledgements

He is very grateful to his trainer Denis Bridoux (email link to DenisBridoux@outcome.demon.co.uk) of

PGPE in Halifax (01422 352961) for his
enthusiastic teaching. Peter fully acknowledges the usefulness of NLP ideas to help organise ideas and
arguments into useful and coherent articles and as a basis for further action."

Note: This article was originally written for Caduceus Magazine in the UK.

2002 Peter Davies, All rights reserved.