Biomedicine and Health Promotion in Britain
In 1995, R.Cook pointed out that health promotion in the NHS had truly become medicalised. The recent spate of healthcare reforms has seen health promotion increasingly ensconced within the NHS, rather than outside of it (Naidoo and Wills 1994). But the NHS, as a bastion of medicine, has very limited ability to tackle the wider determinants of health (Moran 1991). Despite this, GPs, as providers of NHS services to the community, are being sponsored to provide medically-orientated health promotion services. Medicalisation of health promotion represents a narrow conceptualisation of health, for it sees health as occurring within, and being the responsibility of the individual. This is victim-blaming by any other name. Health promotion within the medical model is directed toward the individual without always attempting to address the wider socio-economic and environmental determinants of that person’s health. Indeed, medical models of health promotion could more properly be called the medical models of disease prevention and of health education. To that extent, it can be regarded as a limited subset of wider, more socially-orientated health promotion activity.