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

Photo: Getty Images
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The future of policing is still at risk even after George Osborne's U-Turn

The police have avoided the worst, but crime is changing and they cannot stand still. 

We will have to wait for the unofficial briefings and the ministerial memoirs to understand what role the tragic events in Paris had on the Chancellor’s decision to sustain the police budget in cash terms and increase it overall by the end of the parliament.  Higher projected tax revenues gave the Chancellor a surprising degree of fiscal flexibility, but the atrocities in Paris certainly pushed questions of policing and security to the top of the political agenda. For a police service expecting anything from a 20 to a 30 per cent cut in funding, fears reinforced by the apparent hard line the Chancellor took over the weekend, this reprieve is an almighty relief.  

So, what was announced?  The overall police budget will be protected in real terms (£900 million more in cash terms) up to 2019/20 with the following important caveats.  First, central government grant to forces will be reduced in cash terms by 2019/20, but forces will be able to bid into a new transformation fund designed to finance moves such as greater collaboration between forces.  In other words there is a cash frozen budget (given important assumptions about council tax) eaten away by inflation and therefore requiring further efficiencies and service redesign.

Second, the flat cash budget for forces assumes increases in the police element of the council tax. Here, there is an interesting new flexibility for Police and Crime Commissioners.  One interpretation is that instead of precept increases being capped at 2%, they will be capped at £12 million, although we need further detail to be certain.  This may mean that forces which currently raise relatively small cash amounts from their precept will be able to raise considerably more if Police and Crime Commissioners have the courage to put up taxes.  

With those caveats, however, this is clearly a much better deal for policing than most commentators (myself included) predicted.  There will be less pressure to reduce officer numbers. Neighbourhood policing, previously under real threat, is likely to remain an important component of the policing model in England and Wales.  This is good news.

However, the police service should not use this financial reprieve as an excuse to duck important reforms.  The reforms that the police have already planned should continue, with any savings reinvested in an improved and more effective service.

It would be a retrograde step for candidates in the 2016 PCC elections to start pledging (as I am certain many will) to ‘protect officer numbers’.  We still need to rebalance the police workforce.   We need more staff with the kind of digital skills required to tackle cybercrime.  We need more crime analysts to help deploy police resources more effectively.  Blanket commitments to maintain officer numbers will get in the way of important reforms.

The argument for inter-force collaboration and, indeed, force mergers does not go away. The new top sliced transformation fund is designed in part to facilitate collaboration, but the fact remains that a 43 force structure no longer makes sense in operational or financial terms.

The police still have to adapt to a changing world. Falling levels of traditional crime and the explosion in online crime, particularly fraud and hacking, means we need an entirely different kind of police service.  Many of the pressures the police experience from non-crime demand will not go away. Big cuts to local government funding and the wider criminal justice system mean we need to reorganise the public service frontline to deal with problems such as high reoffending rates, child safeguarding and rising levels of mental illness.

Before yesterday I thought policing faced an existential moment and I stand by that. While the service has now secured significant financial breathing space, it still needs to adapt to an increasingly complex world. 

Rick Muir is director of the Police Foundation