Dr Christian Jessen: "The word 'exploitative' drives me mad"

Helen Lewis talks to Dr Christian Jessen about Twitter diagnoses, self-promotion and the best of the NHS.

Dr Christian Jessen lives an odd life. Quite regularly, people send him photos of their diseased body parts; others seek medical advice from him on Twitter, which he retweets with his response in capital letters before the question. So: “IT’LL KILL YOU IN AN HOUR OR TWO. @DoctorChristian how poisonous exactly?”
 
Dr Christian, as he prefers to be known, is the presenter of Channel 4’s prime-time hits Embarrassing Bodies and Supersize vs Superskinny. In the former, members of the public air their piles, warts and assorted deformities for the benefit of a grateful nation; in the latter, an overeater and an under-eater swap diets for a week in the “feeding clinic”.
 
Both shows have millions of viewers. As a result, Jessen is now our best-known telly doctor (and he is a real one, unlike Gillian McKeith and her internet PhD). But where a previous generation had Robert Winston talking through his trustworthy moustache about the miracle of life, Dr Christian is more likely to go to Magaluf, strip down to his pants and give everyone a pep talk about genital warts.
 
The big question is –why? Why would anyone submit to showing off their bunions, never mind their STI, on national TV? “Sometimes, they’ve been trying for ages to get help and they haven’t been able to get it,” he tells me over juice and pastries at a hotel in London. “Some of them are very political. Some of them are [saying]: ‘I want to promote my condition because I’ve had it long enough and my GP doesn’t seem to understand what it is.’”
 
Isn’t there an element of the freak show? “The word ‘exploitative’ drives me mad. These people have watched the show – it’s been going on for, what, seven series now?”
 
No one can accuse him of not practising what he preaches. He’s spoken about having a hair transplant and his struggle with body dysmorphia, which makes him see a puny weakling in the mirror, when he actually looks more like He-Man. Once, asked on Twitter if he’d ever had an STI, he simply replied: “YES”.
 
Hearing from so many people about their problems, he has a clear perspective on the health service. “The NHS is really, really good at dealing with acute problems, emergencies, major illnesses like cancers. Where it’s not so good is [treating] your ingrowing toenail, your small hernia, your haemorrhoids . . . But what other way is there of doing it, really?”
 
He certainly doesn’t think that the NHS should refuse treatment to immigrants, as some right-wing papers have suggested. “What I like about the NHS – and this is a contentious issue – is that if you’re a poor, African woman with HIV and you know you’re going to die in your country and your children are going to die, if you scrape the money together to get [here], they’ll look after you.” He pauses and flashes a wry, if expensively maintained, smile. “I don’t think we can afford to, but that’s a different issue.”
 
Unlike most doctors I have met, Dr Christian is unafraid of the internet and how it has changed patients’ expectations. He loves to tweet, despite the British Medical Association’s worries about the medium, and in one series of Embarrassing Bodies, people used Skype to consult him. He thinks that video calls could be a scalable solution for those who find it hard to visit their doctor in person (“Most GP questions are: ‘Should I worry? Shouldn’t I?’”).
 
He also doesn’t mind when patients turn up having researched their condition on the web. “I don’t sigh. Well, sometimes I do. Patients come in and they go, ‘Doctor, you gave me these tablets and I’ve just seen that according to the latest trial data they’re not necessarily the right ones.’ That can only be good for us.”
 
Medicine Man: unlike many other doctors, Jessen has embraced the internet. Photograph: Phil Fisk/Camera Press.

Helen Lewis is deputy editor of the New Statesman. She has presented BBC Radio 4’s Week in Westminster and is a regular panellist on BBC1’s Sunday Politics.

This article first appeared in the 19 August 2013 issue of the New Statesman, Why aren’t young people working

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What is the EU customs union and will Brexit make us leave?

International trade secretary Liam Fox's job makes more sense if we leave the customs union. 

Brexiteers and Remoaners alike have spent the winter months talking of leaving the "customs union", and how this should be weighed up against the benefits of controlling immigration. But what does it actually mean, and how is it different from the EU single market?

Imagine a medieval town, with a busy marketplace where traders are buying and selling wares. Now imagine that the town is also protected by a city wall, with guards ready to slap charges on any outside traders who want to come in. That's how the customs union works.  

In essence, a customs union is an agreement between countries not to impose tariffs on imports from within the club, and at the same time impose common tariffs on goods coming in from outsiders. In other words, the countries decide to trade collectively with each other, and bargain collectively with everyone else. 

The EU isn't the only customs union, or even the first in Europe. In the 19th century, German-speaking states organised the Zollverein, or German Customs Union, which in turn paved the way for the unification of Germany. Other customs unions today include the Eurasian Economic Union of central Asian states and Russia. The EU also has a customs union with Turkey.

What is special about the EU customs union is the level of co-operation, with member states sharing commercial policies, and the size. So how would leaving it affect the UK post-Brexit?

The EU customs union in practice

The EU, acting on behalf of the UK and other member states, has negotiated trade deals with countries around the world which take years to complete. The EU is still mired in talks to try to pull off the controversial Transatlantic Trade and Investment Partnership (TTIP) with the US, and a similar EU-Japan trade deal. These two deals alone would cover a third of all EU trade.

The point of these deals is to make it easier for the EU's exporters to sell abroad, keep imports relatively cheap and at the same time protect the member states' own businesses and consumers as much as possible. 

The rules of the customs union require member states to let the EU negotiate on their behalf, rather than trying to cut their own deals. In theory, if the UK walks away from the customs union, we walk away from all these trade deals, but we also get a chance to strike our own. 

What are the UK's options?

The UK could perhaps come to an agreement with the EU where it continues to remain inside the customs union. But some analysts believe that door has already shut. 

One of Theresa May’s first acts as Prime Minister was to appoint Liam Fox, the Brexiteer, as the secretary of state for international trade. Why would she appoint him, so the logic goes, if there were no international trade deals to talk about? And Fox can only do this if the UK is outside the customs union. 

(Conversely, former Lib Dem leader Nick Clegg argues May will realise the customs union is too valuable and Fox will be gone within two years).

Fox has himself said the UK should leave the customs union but later seemed to backtrack, saying it is "important to have continuity in trade".

If the UK does leave the customs union, it will have the freedom to negotiate, but will it fare better or worse than the EU bloc?

On the one hand, the UK, as a single voice, can make speedy decisions, whereas the EU has a lengthy consultative process (the Belgian region of Wallonia recently blocked the entire EU-Canada trade deal). Incoming US President Donald Trump has already said he will try to come to a deal quickly

On the other, the UK economy is far smaller, and trade negotiators may discover they have far less leverage acting alone. 

Unintended consequences

There is also the question of the UK’s membership of the World Trade Organisation, which is currently governed by its membership of the customs union. According to the Institute for Government: “Many countries will want to be clear about the UK’s membership of the WTO before they open negotiations.”

And then there is the question of policing trade outside of the customs union. For example, if it was significantly cheaper to import goods from China into Ireland, a customs union member, than Northern Ireland, a smuggling network might emerge.

 

Julia Rampen is the editor of The Staggers, The New Statesman's online rolling politics blog. She was previously deputy editor at Mirror Money Online and has worked as a financial journalist for several trade magazines.