Biomedicical Influence on "Health"

According to Bury (1998), modern medicine came into being at the turn of the 20th century, "this involved the acceptance of an objective view of disease based on the idea of specific causes linked to infectious diseases and germ theory." Illness meant calling the expert, a doctor restricted by a regulated professional organisation, practising a reductionist approach to health care (MacDonald1998).

The health service, because of its bio-medical orientation, has a very limited ability to tackle the wider determinants of health. Primary Care Trusts have been set up within the community to encourage public participation and intersectoral collaboration, but the fact remains these groups are dominated by GPs, who fear losing their power.

There are many reasons for the threat to the influence of the GP in recent years. Illich (1975) pointed out, that by becoming more focused on illness states, medicine has largely marginalized itself from the majority of healthy people.

We live in an age of science; and throughout this century in particular man has made extraordinary progress both in his understanding of the universe and the use of scientific knowledge to improve quality of life. One must also consider negative aspects, we are chopping down forests, pouring noxious substances into our environment, destroying ecosystems, possibly bringing about long-term and perhaps irreversible changes to the world's climate and people's health. It is incumbent on everyone to question current government policies if we have any concern at all for future generations.

The pharmaceutical industry has a major influence on UK government health policy (£4 billion a year]. Is it possible that over prescription of drugs particularly antibiotics, and vaccinations have damaged the immune systems of a generation.

According to MacDonald (1998), Hygea was the guardian of health who symbolised the belief the men could remain well if they lived according to reason. Panacaea achieved fame not by teaching wisdom, but by mastering the use of the knife and the knowledge of the curative virtues of plants. As medicine has developed through history, this division in approach has been preserved with dominance afforded to intervention rather than well-being.

In 21st century culture, science along with its high tech applications predominates. The glorification and adulation of science gives the word scientific a connotation of quality, it has become a synonym for being excellent, trustworthy and reliable. "Most scientific enquiry is driven by the requirements of industry or government rather than the pursuit of knowledge" (Fulcher and Scott). Commercial interests determine funding, and influence the outcome of trials. Pharmaceuticals are a billion-dollar industry; an effective drug marketed well, makes shareholders happy.

The US Government spends US$250 million a year on polio, a disease it has irradiated. Governments are dependent on a successful economy and the large multi national companies who have influence on the financial markets. The amount of money a government spends on health is dependent on taxes, a derived demand, based on the consumer's income and absence of illness which is desirable for the full enjoyment of all other production and consumer activities.

The providers of health care are specialised institutions established in the shapes of clinics, hospitals and research laboratories, their practices and principles helping to "extend the medical monopoly into every day life and maintain the social control mechanisms over an apparently docile population" (Bury 1998). The managers in these institutions are charged with maintaining the status quo, as opposed to adapting their approach from the management of disease to the conservation of health" (Tudor-Hart 1988).

MacDonald (1998) states, "Medicine is an intrinsically political activity and not the neutral and dispassionate clinical science" consumers expect, therefore conflicting influences can have a bearing on the requirements of the individual. McGuire et al (1995) ask, "is not health such a fundamental concern that absolute priority should be given to maintaining and improving it?". Unfortunately resources are scarce and choices have to be made on how to allocate these resources with least cost. Health care is a commodity, something that can affect the economy, so governments start looking at it in terms of cost rather than optimising human potential.