And then Britain started to grow up and tug at the constraints. We got fed up with killjoy licensing laws that were more puritanical than those of other nations in Europe. So they were relaxed. Alternative medicine thrived as people sought out their own cures among herbalists, aromatherapists and reflexologists who plied their unregulated wares beyond the doctor's surgery. No prescriptions were required. In a culture of complaint, consumers stopped just accepting what they were given: they demanded better and quicker NHS treatment. Meanwhile illegal drugs such as cannabis and Ecstasy grew popular, no matter how often they were officially condemned or what laws were passed against them.
Then this week we saw further signs of retreat by the nanny health state. Faced with scientific evidence that advice to the public on alcohol consumption pitched the recommended limits too low, Stephen Dorrell had a problem. Should he listen to nannying doctors, who would keep the happy news a secret? Or should he tell the truth and let people decide for themselves? Mr Dorrell made his choice. He rejected the old view that the public deserves only those truths that guide behaviour towards a desired end. He treated us like adults. Cheers, Mr Dorrell.
But in loosening its authoritarian hold on health, the state has got into unfamiliar difficulties. It has also lost its authority. Now we are encouraged to make up our own minds about health issues, we've turned into cynics. We don't trust Mr Dorrell when he says it's safe to drink more. Is he in cahoots with the brewers, we wonder? Was his announcement no more than a scam to top up Christmas drinking and boost the Treasury's tax revenue? Was he, perhaps, trying to increase the feel-good factor?
As for his advice on eating beef, many people think that it stinks as badly as a month-old steak. Ministers speak with great certainty that there is no doubt about the safety of beef. They tell us that they are stuffing the faces of their children with hamburgers. But they may as well be trying to sell turkeys on New Year's Day: few people are buying the message.
The suspicion, right or wrong, is that ministers are in the pocket of the livestock industry. Thousands of people are simply giving up on beef. Consumers know that scientific opinion is divided and some have decided that the risk, however minor, is not worth running.
Even when the state is absolutely honest and comes clean with up-to- date information, it ends up in a mess. The warning in October about the increased dangers of thrombosis posed by seven brands of the Pill scared millions of women. They were told of the discovery, via the media, at a hastily arranged press conference. The evidence comprised three unpublished studies that family doctors, suddenly besieged by anxious women, had not seen. The extra danger was not huge in comparison with some health risks: pregnant women still face twice the risk of thrombosis as someone on the condemned contraceptives. Panic reigned.
All of this is indicative of a wider truth: the Government is neither trusted in its health pronouncements nor particularly adept at getting its message across. Ministers can't win: they are attacked either for being silenced by powerful vested interests or for going in for unnecessary scaremongering. As the Lancet, a medical magazine, comments in this weekend's edition, health alerts are handled "more often badly and seldom perfectly".
So what should the Government do? It should continue to dismantle the nanny health state and replace it with the information state. This would establish the Government not as a source of health rules and prohibitions, but of data that people can genuinely trust as unsullied by lobbying interests. That way we could properly make up our own minds about what to eat, smoke and drink.
Greater openness should be combined with greater sensitivity. The Lancet's editor, Dr Richard Horden, struck the right tone yesterday when he said: "One needs to disclose the information on which a decision has been made at exactly the same time as the clinical alert comes out. Otherwise one leaves doctors and patients completely in the dark."
The blame for health information failures does not lie solely with the Government. The media also bear some responsibility. Over the past year newspapers and broadcasters have blown up the threat of sensational diseases such as the "killer bug" and of India's plague. In each case news of the infection consumed us for about a week and then disappeared without trace. There will be other such instances even in the coming weeks: the incidence of meningitis is already being reported feverishly even though more than 2,000 people contract (and 150 die of) the disease in any normal year. Likewise, the occasional flu death should not be over-reported, given that 3,000-4,000 people die of the illness even in non-epidemic years.
The media have some incentive for keeping these stories in proportion: a newspaper, for example, that gains the reputation for being absolutely accurate can expect to put on, rather than lose, sales. But competition can put enormous pressure on the truth.
It is for the Government to recognise the atmosphere into which it releases information and the short attention span of the media. Its aim should be to generate light as well as heat. We need less of the nanny, more of the sister or brother.Reuse content