The start of my working week is Sunday evening. A glass of Penderyn sits on the corner of the desk and whispers; '...come dancing'.
Lewis Hamilton is whirring his way around a track that has all the attraction of a Walmart car park. Spa it is not.
In the news; Tony Blair apologised for Iraq. Hardly news. He said the same thing months ago.
If it's possible to park the emotions that Blair incites, I think he was responsible for one of the bravest and most far reaching decisions of the twentieth century.
The impact was immediate; 2.4% reduction in heart attack, emergency admissions to hospital (1,200 patients) in the 12 months following the ban.
Blair succeeded where years of persuasion, nudge, adverts of people coughing and images of kissing ashtrays failed. He changed the law.
A controversial but mesmeric man, Thomas McKeown, was both a doctor and a demographer. Back in the 60's he said (in terms), governments have done all they can, about public health; clean water, adult literacy and childhood immunisation. He went on; ...the rest depends on the extent to which government is prepared to interfere in the lives of ordinary people.
He is right. Blair is right. It is the law that changes behaviour. Seat belts in cars, crash helmets whilst riding motor cycles, health and safety at work and smoking in the work-place. The law keeps us safe.
Before 1900 it is probably true to say doctors did more harm than good. By the 30's they were changing the balance and since then real changes have come thick and fast.
McKeown said the major advances in health came not from therapeutic medicine but from "...improvements in the economy, in diet, in public-health engineering and in the evolution of social and working conditions."
Get that... public-health engineering.
Taking care of the public's health is a mile away from fixing them up when they get sick. Each is the servant of the other but only one has the power to stop the NHS melting.
More from last week's news... the sugar tax thing. I guess it will be in the news again this week and next week and the week after. Until Number 10 manages to find an apparatchik with a right foot, sure enough, to kick it into the long grass.
Sugar; tax it, ban it, demonise it? You're joking; we can't agree on how big a spoon is a spoon! Public Health England reports seem to have less impact than a letter to Santa... we know Santa's letters always get a result.
Public Health England, responsible for everything from Ebola to what goes in a sausage. From Porton Down to feathers in your eiderdown. If ever there was a leviathan, PHE it is. Sprawling, confused, meandering, ponderous, touchy, prickly, defensive, impenetrable, out of touch, out of the loop and out of my life and probably yours, too.
I can't figure out if PHE is arm's length from government, independent, a servant, supine or just too big to do anything nimble and meaningful. They seem to have all the clout of a wet lettuce leaf... sprayed with Imidacloprid, Mandipropamide or Propamocarb hydrochlorine... or not. Given time, I expect PHE could tell us.
Fixing the NHS on the supply side is all but impossible. Fixing our health on the demand side is slipping out of our reach.
Lifestyles, diet, incomes, education, new definitions of poverty and ignorance are driving the nation's health into a cul-de-sac of our own making.
Where are the public health leaders? Where are the champions of 'public-health engineering'? Who will, to interpret McKeown for our times, help us to; come safely into this world and comfortably out of it and whilst in it, protect our wellness and superintend our healthiness.
Who will redefine medicine and take a lead in understanding the true nature of the times we live in. Where are the public heath champions, their professional cream-of-the-crop, their leaders?
Who will confront our politicians and challenge us as individuals, with the uncomfortable fact that nutrition, the environment and our behaviour are all that matters? Not a PH professional but a chef off the telly...
