Intended for healthcare professionals

Rapid response to:


Public health and preventing violence

BMJ 2011; 342 doi: (Published 16 June 2011) Cite this as: BMJ 2011;342:d2882

Rapid Response:

Lessons from Violence Prevention and the Prevent Strategy

We work hard at improving our management of high tec illness in older
people but ignore deaths and injuries in young people. The WHO has
declared that violence is a public heath problem. More youngsters in my
practice have died from stabbing than Tb. Gangs are a problem so it is
reassuring to see Professor Shepherd in Cardiff and the work in Scotland
(see addressing violence in young men via
multidisciplinary working.

This contrasts with the BMA response to the
Home Office's Prevent Strategy that deals with terrorism (BMJ
2011;324:d3645). Rather than focus on what the majority of the document
discusses it concentrates on an extremely unlikely scenario of a potential
terrorist disclosing information to his GP and the resulting ethical
dilemma. Terrorism is very rare. With at least 30,000 GPs in the country
the chances of having a terrorist patient are very small. Most terrorists
have no mental health problem and are in an age group where they are
unlikely to consult a doctor. More pertinent is a discussion about those
vulnerable people who may be attracted into a seductive group identity
offered by terrorist organisations or gangs. As GPs we are increasingly
aware of literature about inequality and its impact on a sense of being
disadvantaged and disenfranchised. The underlying purpose of Prevent is
about agencies developing discussions to improve inclusion and community
cohesion to prevent terrorism and make prosecution unnecessary. Most
Doctors would feel comfortable with the large majority of Prevent and in
my view the BMA and GMC should wholeheartedly approve of its message
involving doctors protecting their vulnerable patients from violence.

Competing interests: No competing interests

15 July 2011
Neil Frazer
GP/ Forensic Physician
North Westminster