How effective do you want to be

primary_care_training_starbucks

On the train, the first thing Anji does is find her iPhone and scroll through Facebook.  Her SoMe, morning routine.

Friends, nights-out, holidays, meet-up-messages, adverts and the lives of celebrities... so different to her daily slog at the office.

Onto Twitter and finally emails.  Anji doesn't do many.  Her Dad uses it, to see how she's doing.  Adverts from the bank  Nothing interesting... except, this morning.

The red type face stood out against the rows of black.  'Urgent and Personal'.  

She touched it open.

It was from NHS Public Health Wellness Data Authority.

Wellness Tax Discount (WTD) Scheme.

'This is to advise you the total of your Tesco Home Delivery product points, purchases in Costa and Starbucks and the out-put from your FitBit activity creates a negative WTD score for the first quarter of 2022; January, February March.

This score cannot be discounted by the use of your gym membership.  The membership card has not been accessed since January 15th.

Analysis of your credit card spend shows 23 ancillary purchases of high calorie snacks, with product scores of over 200.

Your Amazon account details an exchange of a clothing item for a size larger than your normal purchase.

This is to advise you, your WTD account has been deducted 231 points and your employer will make the appropriate adjustment through your personal tax-code.  

The penalty amount is £23 a month for ten months taken at source.

The email ended with links to NHS Choices, WeightWatchers and NHS Digital Appeals.

Anji looked out as the rain streaked the train window... she'd go to the gym tonight... the cafeteria and use cash to buy a latte.  Stuff the public health police and the WDT.

Had she made different choices, she might have had a contribution from the WDT, reducing her tax bill... fat chance.

On the M6 it was pouring with rain.  Dave swung his BMW3 into Burton Services.  A strange looking building... 'More like a conservatory than a cafe', Dave said to himself.  He found a parking space, ran, through the rain and headed for MacDonald's.

Great, no queue.  He smiled at the girl behind the till.  She must be new, thought Dave, her red baseball cap came down over her ears.

He ordered his usual and in minutes was tucking into a Mac Big-Breakfast.  Seven hundred and fifty calories.  Not that Dave cared.  He'd been up since 5, hacking though fifty miles in a rain storm.  He was starving.

He flicked though his emails.  Sales department numbers.  Accounts wanting him to check an unpaid invoice, SunGlass Hut, the pizza company with a special.  One, asking if he could play a Wednesday evening game next week.

Amongst the junk the red print of one email stood out. 

It was from NHS Public Health Wellness Data Authority.

Wellness Tax Discount (WTD) Scheme.

The upshot; they had used the location of his mobile phone and weather data to 'advise him' the 'average speed-journey time' had exceeded safe limits for the conditions and a health-risk tax-penalty of £20 will be deducted at source for three months.  A £60 fine...

There was more; 

Estimates based on his purchases indicated ... daily calorie count, food and alcohol choices were 'endangering his wellness' and a compulsory appointment would be made for him, with a local, lifestyle-management coach... to 'discuss the options'.  His employer would be notified accordingly.

His credit card would be blocked for purchases from a list of fast-food outlets'.  

There was a link to the list.

'That's all I need'  He swallowed the last forkful  of sausage.  On the way back to the car he took £100 from the cash machine.  Stuff the WTD, he enjoyed his breakfasts.

Big-data aggregations.  They came about after Parliament examined Facebook.  Bingo!  Linking data was easier than politicians thought.  

In exchange for unregulated license to continue operating his advertising based platform, founder Mark Zuckerberg set to work on WellBook, the government's new approach to public health.  

An algorithm linking public health programmes and all data subject to the controversial, revamped Data Protection Act 2020, creating total lifestyle analysis 

'... to shape the safer lifestyles that 

benefit us all....'

Havin' a larf?  Yup but it's innovation!  It's what the NHS wants, isn't it?  You know and I know, from what we have learned from Zuckerberg at the US Senate hearings... easily doable.

We keep throwing money at public health, with what effect?  The question is; how effective do you want to be?

Have a good weekend...

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roy.lilley@nhsmanagers.net 

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Disclaimer

Reproduced at TrainingPrimaryCare.com by kind permission of Roy Lilley.