White Paper: creates opportunities but lacks strategy

The Forum has given a cautious welcome to the government's white paper Choosing Health published last Tuesday acknowledging that it does create opportunities to improve men's health.

The Forum's director Peter Baker said 'The white paper fails to address men's health at a strategic level but the overall approach does create opportunities to improve it. Although, there are many references to tackling health inequalities and the need to develop tailored approaches to specific population groups, there is in fact no mention of gender at all at a strategic level.'

Only two groups of men are specifically mentioned: young men and prisoners and there are a number of statistics on men's health, including the high level of suicides amongst young men. Baker concluded: 'The white paper creates a framework within which men's health can be improved — the emphasis on the workplace, for example - but the crucial test will come at the delivery plan stage which is scheduled for early 2005. It is there that we should be looking for concrete commitments on men's health.'

The government says that the white paper is based on the principle of informed choice. Research published in the latest British Medical Journal suggests the main issue is not lack of choice but lack of involvement. According to a study from the Commonwealth Fund of New York comparing nearly 9,000 patients from the USA, Australia, New Zealand, Canada and the UK, British patients receive less information about medicines, less preventative advice, less help with managing chronic disease at home and have poorer access to their records than other countries.

A third (37%) of surveyed UK patients taking regular prescription medicines said their doctor had not reviewed their medication in the past two years. And 39% said they had not received an explanation of likely side effects of their medicines. A 'notably worse' result than the other countries.

Only 27% of British patients felt their doctors had engaged them in making decisions about their healthcare, or offered them choices compared with 41% in New Zealand. And just 28% reported receiving advice on weight, nutrition and exercise, compared with 52% in the United States.

The BMJ editorial argues that substantial evidence indicates that patients engaging actively with healthcare is highly beneficial and often results in more cost effective use of health services and better health outcomes but that the new contract for family doctors fails to recognise or encourage this.

Jim Pollard, editor of the Men's Health Forum website says: 'Choice, as ever in public services, is a bit of a red herring. People don't want to choose between umpteen equally distant, equally overworked physicians, they just want one who has the time, skills and resources to take them and their health problems seriously.'

The Forum will be producing a briefing note for its members and others which will also be posted on this website in January. We will also be writing to health secretary John Reid about our concerns and setting out what we would like to see in the delivery plan. The issue will also be raised with public health minister Melanie Johnson at the All Party Group on Men's Health meeting in February.'

• Download Executive Summary of White Paper.
• Download Easy-to-read Summary for the general public