Glasgow has recently become the home of the

. first British Well Man

Clinic. Lucy Ash visited

T the clinic to find out how it works.

‘I don‘t know doctor. I’ve come over all funnylike . . . .’ Like the sit-com mother-in-law. the middle-aged woman who badgers the doctor into prescribing endless ‘placebos' is a familiar target ofridicule. Yet the comic stereotype is revealing: most

women take their health more seriously than men do.

‘The family car probably receives more care and attention than the average adult male‘. says Bob Hoskins. a Castlemilk health visitor who. with his colleague. Bill Deans. has set up Britain‘s first and only

; nurse-run Well Man Clinic. ‘Men

don‘t like to bother the doctor with

. “trivia”.’ says Deans. ‘Ofcourse. the macho image is partly responsible.

i but it is also worth remembering that until comparatively recently men

._ found it difficult to get sick leave or

g time off work to visit the surgery.‘

1 Statistics show. however. that

E Glaswegian men can no longer

5 afford to neglect their health.

i Scotland has the worst premature

: death rate from heart disease in the world today and Glasgow is worse

\“ Q‘V‘

~ 3“.\.“-':! .


than the Scottish average. Every year there are nearly 6.500 deaths in the city from coronaries and strokes. and 1.450 of these are in the under 65 age group.

Because Castlemilk‘s population of30.()()() comprises mainly young to middle-aged families. Hoskins and Deans spend most of their time managing mother and baby clinics and dealing with routine vaccinations. However they soon sensed a gap in their practice where were all the husbands and fathers? The national view of the Glaswegian male as a pot-bellied chain—smoker who spends most ofhis time in the pub seemed disturbingly accurate in Castlemilk. This vast Coucil estate of overcrowded damp tenements.

where more people live per square

Family car receives _ ___m9r¢.9%1r5_

acre than anywhere else in Europe. and where unemployment runs at 45%, provides a far from healthy environment.

Hoskins and Deans noted the paradox that while men have a higher morbidity in heart and lung diseases than women. there is little or no provision for them in the health visiting service or any other NHS facility unless they are actually ill. Thus after much research. discussion and advice from specialists. they set up their Well Man Clinic as a pilot scheme in primary prevention last April.

After sending out 500 letters to names drawn at random from a local practitioner’s list, the two health





visitors managed to get 100 men between 20 and 60 years old to come for a routine check-up. ‘We knew that many men would automatically throw the appointment letter away. so we had to concentrate on "selling" techniques. We hoped that our “special offer“ of a free and comprehensive screening programme would act as a bait and lure people into the Centre.‘ says Deans. In fact the Well Man Clinic does offer a real bargain; some

private health companies which have

jumped onto the prevention of heart disease bandwagon charge as much as £150 for similar screening programmes.

Imaginative presentation. however. is vital to the success of the scheme. ‘People have a weakness for different kinds of gadgetry and we offer them the full range even though some may be superfluous”.

A weakness for gadgetry

Deans admits. At the recent Health Fair on Glasgow Green. men were

going up to have their blood pressure

taken at the Well Man Clinic stall just as they would punch a punchbag and watch a flickering needle measure their ‘virility’ at a fairground.

Deans and Hoskins have also devised a colourful ‘heart chart‘ based on the traffic light system. Risk factors such as weight. smoking or a family history of heart disease count as penalty points. and clients

with high scores are in the red danger

zone their lifestyles need ‘a major overhaul’. A medium score is amber coloured for caution and shows several 'blackspots in need of servicing‘. whereas a low score is given the green light. although the client should be alert to ‘hazards ahead‘. “It may seem silly but we wanted to introduce an element of fun and competition and we try to avoid using medical jargon which could alienate people‘. Hoskins points out.

About three months after the first appointment the client returns for a


fresh assignment hopefully having modified his diet and some damaging habits. such as drinking and smoking. However both health visitors feel that preaching about high fibre diets. exercise and giving up cigarettes. is likely to elicit a negative response. They pride themselves on giving ‘realistic advice‘. and on encouraging men to play an active role: ‘I don‘t tell someone to lose two stone‘. says Deans. ‘I say. “how much do you think you could lose in a month?" and try to strike up a contract with him.‘

Dean and Hoskins are not surrogate doctors; clients needing medical attention are sent to their GP with a letter. Nevertheless. Hoskins. who has an RMN qualification from his training at Leverndale Mental Hospital is well equipped to discuss psychological stress with the long-term unemployed. whereas Deans

Pilot scheme in primary. prevention

specialises in family planning advice and tries to promote greater male ' responsibility in sexual relationships.

The Well Man Clinic has been

enthusiastically received by the Greater Glasgow Health Board which launches an £8 million cardiovascular disease prevention campaign next spring. The goal of the ‘Good Hearted Glasgow‘ campaign is to reduce the number of - cases ofcoronaries and strokes by 10% over the next ten years. Although Hoskins and Deans are at present unable to devote more than one afternoon a week to their Well Man Clinic. they have been closely involved with the planning ofthc Good Hearted Glasgow campaign and have advised on how to set up a network ofsimilar health centres throughout the city. 0 The Well Man Clinic is in Armprior Quadrant, Castlemilk, Tel. 041 634 7303. It is not an open access clinic, but does accept some referrals. For details phone above number.


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48 The List 15-28 November