The “Nanny State” …. Collective well-being!

Do you ever just drive and forget to put on your seatbelt? My car doesn’t make that annoying beeping sound to remind me, but I usually have two incessant “beep-beeps” behind me that are champions of road safety and remind me to  buckle up. But I didn’t have them with me last Monday evening as I drove onto the M50  and was pulled over by an eager Garda Road Traffic Corps unit. I was rightly issued with a ticket resulting in a fine and points on my licence for not wearing my seat-belt. Now, I could of argued that I was driving a car incapable of breaking 55 mph and that realistically a seat belt would do little to protect me when driving a 1973 VW beetle tin can, but I didn’t. Some would argue that this is the action of a “nanny state”, a paternalistic political system that saves the people from themselves. At the core of a nanny state is the belief that individual freedom isn’t the central value of a democratic culture,  collective welfare must take priority. The nanny state restricts the choices of competent adults  because apparently when people are given the freedom to choose they choose wrongly! Its for your own good. Liberal thought would advocate that it is the business of the government only to interfere when we are at risk of harming others. Its often referred to as Mill’s principle. After John Stuart Mill, a famous liberal, utilitarian and early feminist of the eighteen hundreds. In his influential text “On Liberty” he wrote  “the only purpose for which power can be rightfully exercised over any member of a civilised community, against his will, is to prevent harm to others. His own good, either physical or moral, is not a sufficient warrant”.

CCTV-camerasThis nanny state is happy to look after you and save you from yourself provided it can make a profit by punishing you if you step out of line – fines for not wearing  a seatbelt, increased taxes  on sugary drinks amongst others.  No one likes taxes and fines, so rather than punish people financially for choosing badly, would it not be more effective to offer tax credits and incentives for “good behaviour”. Is it more beneficial to introduce measures that are positive incentives rather than negative ones? Maybe a motivational tax credit rather than a punitive tax on sugar may work better. Because a sugar tax doesn’t work. It hasn’t worked in other countries, studies from Finland, Denmark, Hungary and France suggested only a short term reduction in the spending on sugar.  In the first year of the sugar tax since May 2018 Irelands craving for sugary fizzy drinks generated nearly 32 million for the exchequer, but not a cent of this has been spent on battling the country’s current obesity crisis.   Using these funds to remove barriers to healthier lifestyles would be a start. Expensive gym memberships, a need for appropriate equipment, qualified coaches and advice, a lack of available and accessible green spaces and “dangerous” parks are barriers and can get in the way of turning free time into active time (Mytton et al., 2012). Our surrounding environment, policy decisions, parental modelling and societal influences have incredible impact on the activity levels of children and adults. Positive financial incentives, e.g. subsidising the price of participation in activities could potentially lead to a huge increase in quantity of physical activity in all populations regardless of age (Anokye et al., 2014). Consistent exercise contributes to the prevention of premature death, cardiovascular disease, ischemic stroke, type 2 diabetes, some colon and breast cancers, and even depression (Carlson et al., 2015).  It is so powerful at maintaining and improving health that it can add not only years to life but quality to those years. It can produce transformational changes in fitness levels, mental, social, emotional health and wellbeing. Increasing levels of activity in the Irish population could ultimately result in annual saving of between €67.5 – 135 million. A British study reported that non adherence to exercise and activity guidelines was directly responsible for an approximate cost to the British National Health Service of at least £1.06 billion(Allender et al., 2006). Generally our policies tend to be reactive and negative  rather than proactive and positive. With this in mind should people who choose to be inactive and prove costly, just like I chose to not wear my seatbelt, pay a fine for the collective good?

References

ALLENDER, S.; COWBURN, G.; FOSTER, C. Understanding participation in sport and physical activity among children and adults: a review of qualitative studies. Health Education Research, v. 21, n. 6, p. 826-835,  2006. ISSN 0268-1153. Disponível em: .

ANOKYE, N. K.; POKHREL, S.; FOX-RUSHBY, J. Economic analysis of participation in physical activity in England: implications for health policy. Int J Behav Nutr Phys Act, v. 11, p. 117, Sep 14 2014. ISSN 1479-5868. 

CARLSON, S. A.  et al. Inadequate physical activity and health care expenditures in the United States. Prog Cardiovasc Dis, v. 57, n. 4, p. 315-23, Jan-Feb 2015. ISSN 0033-0620. 

MYTTON, O. T.  et al. Green space and physical activity: an observational study using Health Survey for England data. Health Place, v. 18, n. 5, p. 1034-41, Sep 2012. ISSN 1353-8292. 

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I qualified with an Honours degree in Physiotherapy from Trinity College Dublin in 2004. Since graduating I have worked in St. James Hospital Dublin and have worked in all the areas of speciality within the hospital including cardiorespiratory, orthopaedics, rheumatology, care of the elderly, neurology, burns and plastic surgery among others . I have also completed a post graduate certificate in acupuncture in UCD 2009. The Physiotherapy Department in SJH has strong links with Trinity College Dublin (TCD) and I have supervised undergraduate and postgraduate physiotherapy students on practice placements and also delivered lectures on the undergraduate academic programme in TCD. I have a keen interest in all sports and currently plays with Cill Dara RFC 1st team squad, and Milltown GAA. I have previously worked as Physiotherapist to Co. Carlow Senior GAA Team, Milltown GAA, Leinster Junior Rugby Team and Cill Dara RFC. I am an experienced runner and competed in the Dublin City Marathon in 2002. I continue to participate in running events and multisport disciplines such as Gaelforce West, Gaelforce North and the Motivate Challenge. I have a particular interest in strength and conditioning. I utilise this knowledge of resistance training in the treatment of his clients. I am committed to continuous learning and development in order to ensure the optimal level of care is offered to my clients, and with this in mind I am currently undertaking a certification in Strength and Conditioning (CSCS) with the NSCA.

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