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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Today's immigration figures show why the net migration target should be scrapped

We should measure different types of migration separately and set targets that reflect their true impact.

Today’s net migration figures show, once again, that the government has raised expectations of tackling migration and failed to deliver. This is a recipe for disaster. Today’s numbers run far in excess of 300,000 – three times over what was pledged. These figures don’t yet reflect the fallout from Brexit. But they do show the government needs to change from business as usual.

It has been the current strategy, after all, that led the British public to reject the European Union regardless of the economic risks. And in the process, it is leading the government to do things which err on the side of madness. Like kicking out international students with degrees in IT, engineering or as soon as they finish their degrees. Or doubling the threshold for investor visas, and in the process bringing down the number of people willing to come to Britain to set up business and create jobs by 82 per cent. Moreover, it has hampered the UK’s ability to step up during last year’s refugee crisis - last year Britain received 60 asylum applications per 1,000 people in contrast to Sweden’s 1,667, Germany’s 587 and an EU average of 260.

The EU referendum should mark the end for business as usual. The aim should be to transition to a system whose success is gauged not on the crude basis of whether overall migration comes down, irrespective of the repercussions, but on the basis of whether those who are coming are helping Britain achieve its strategic objectives. So if there is evidence that certain forms of migration are impacting on the wages of the low paid then it is perfectly legitimate for government to put in place controls. Conversely, where flows help build prosperity, then seeing greater numbers should surely be an option.

Approaching immigration policy in this way would go with the grain of public opinion. The evidence clearly tells us that the public holds diverse views on different types of migration. Very few people are concerned about investors coming from abroad to set up companies, create jobs and growth. Few are worried about students paying to study at British universities. On the other hand, low-skilled migration causes concerns of under-cutting among the low paid and pressure on public services in parts of the country that are already struggling.

The first step in a new approach to managing migration has to be to abolish the net migration target. Rather than looking at migration in the aggregate, the aim should be to measure different types of migration separately and set targets that reflect their true impact. In the first instance, this could be as simple as separating low and high skilled migration but in the long term it could involve looking at all different forms of migration. A more ambitious strategy would be to separate the different types of migration - not just those coming to work but also those arriving as refugees, to study or be reunited with their families.

Dividing different flows would not only create space for an immigration policy which was strategic. It would also enable a better national conversation, one which could take full account of the complex trade-offs involved in immigration policy: How do we attract talent to the UK without also letting conditions for British workers suffer? Should the right to a family life override concerns about poor integration? How do we avoiding choking off employers who struggle to recruit nationally? Ultimately, are we prepared to pay those costs?

Immigration is a tough issue for politicians. It involves huge trade-offs. But the net migration target obscures this fact. Separating out different types of immigration allows the government to sell the benefits of welcoming students, the highly skilled and those who wish to invest without having to tell those concerned about low skilled immigration that they are wrong.

Getting rid of the net migration target is politically possible but only if it is done alongside new and better targets for different areas of inward migration – particularly the low-skilled. If it is, then not only does it allow for better targeted policy that will help appease those most vocally against immigration, it also allows for a better national conversation. Now is the time for a new, honest and better approach to how we reduce immigration.

Phoebe Griffith is Associate Director for Migration, Integration and Communities at IPPR