Secret agendas

we'll play by the rules to get the money, but we have two layers. The one to get the bucks, and the other that says: this is really what I'm at.

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The secret agendas of health promotion

A recent paper 1 published in a leading health promotion journal reveals the 'fanatical zeal', 'secretive' processes and 'hidden agendas' of some health promotion professionals.

The article 'Working invisibly' concerns a study of the motives and practices of health promoters. The research found that many workers in the field openly manipulated health promotion projects in order to establish their own, covert programmes. ".we'll play by the rules to get the money, but we have two layers. The one to get the bucks, and the other that says: this is really what I'm at."

The authors of the paper - all health promotion specialists themselves - note that: ". workers' own language and phraseology reveals the strength of intensity of purpose - a mission. It involves persistence and suggestion, almost like indoctrination . The work involves 'vision', 'selling' and double messages."

The term used by health promoters to describe these hidden aspects of their role is 'capacity building' - ostensibly helping people to help themselves but, in reality, encouraging them to adopt 'correct' lifestyles. In doing so, the workers far exceed their legitimate function and the terms of the grant aid that they receive.

Some health promoters recognised the dangers of this approach: ". the implied paternalism and 'egocentricism' (sic) of health promotion working in this way made them feel uncomfortable (for example, the view that 'I am going to develop you')."

It is clear, however, that such reservations were expressed by only a minority of health professionals. The majority were keen to justify, and were even proud of, the way they deceived both their paymasters and their clients.

The authors also note that: "A consequence of working invisibly is that work is not subject to quality control"

This, in SIRC's view, confirms the need for a Code of Practice to regulate the activities of health promotion 'professionals' and to ensure that 'missionary zeal' does not replace sensible and scientifically based health advice.

To read Penny Hawe's reply to this article, click here.