Infantilised and deferential, we modern patients must take on more responsibility for our own welfare

Guardian

Having succumbed to the worst flu in years and watched plenty of friends, colleagues and family get mown down in the past few weeks, it seems you have three options. One, you go to ground, stay incommunicado in bed, and at least you don't inflict your misery on anyone else (effective but extremely depressing). Two, go to bed but only after ensuring a constant source of sympathetic nursing (very effective but only available to men with long-suffering wives. Question: however did feminism convert hypochondria from being a female condition in the 19th century to being primarily a male one in the 20th?) Three, you indulge in a deeply emotionally satisfying plaint about the inadequacies of the NHS, the iniquities of NHS Direct and your useless doctor who won't even come and see you, damn it, anyone would think they were celebrating Christmas as well.

It is the third option which we have gone for as a nation. Newspapers are fuelling a grumbling resentment that getting flu is somehow all the government's fault, and certainly the absence of an instant cure is. All sorts of political opportunists with their own agenda of private health insurance are seizing the flu epidemic as grist to their mill, arguing that it shows the NHS just can't cope. But the harsh truth is that it is not the NHS which is to blame, but probably you if you are under 50.

We pour huge amounts of rubbish down our throats, we sit about hunched over computer screens or slumped in front of the TV, get exhausted rushing around going to Christmas parties, shopping, visiting; we spend an enormous amount of time worrying about everything from work to what fridge to buy in the sales, and all the while still expect our bodies to happily transport us about, brimming with a sense of well-being. We regard our immune systems as a built-in software which occasionally needs updating (vaccinations) but otherwise runs itself pretty well.

You can see in our attitude to our health the merging of two ways of thinking which are generating unprecedented pressure on the NHS. The first is our mechanistic view of our body: if it goes wrong, we take it to the mechanic to tweak the odd bit of machinery and put it right. There is a pill for everything, and always a doctor somewhere who knows exactly what is wrong and what to do about it.

This is the perception which has increasingly dominated the 20th century, deliberately fostered by a billion-pound pharmaceutical industry with a vested interest in our faith in its products and encouraged by a paternalistic elite (the medical profession), keen to protect their - literally - hallowed status. One of the by-products of this was the professionalisation of healthcare; knowledge of herbal remedies, even nursing skills, were once common. Now "just leave it in our hands" has been the mantra of doctor and drugs salesman, and happy to be reassured - and infantilised - we have been deferential patients.

More recently, a second way of thinking, the consumer mentality, is emerging which will revolutionise healthcare in many ways over the next decades. It brings much higher expectations of what health consists of - emotional, sexual, as well as physical, well-being - as well as higher expectations of health delivery in terms of availability, choice of treatment or doctor and, above all, expectations of guaranteed results. A cure for everything, instantly, and I want a complaint form if I'm not satisfied.

Both ways of thinking have huge faith in western medicine. It is a shibboleth of our belief in progress that we are healthier than any of our ancestors. It is true that antibiotics and vaccinations have hugely helped our control of infectious diseases and the development of surgery (though doomsayers will claim that such has been our misuse of antibiotics that there may be a vicious sting in the tail of that medical wonder).

But as regards general health, our complacency is not entirely justified; Robert Lacey and Danny Danziger point out in their book, First 1000, that our Anglo-Saxon forebears at the turn of the first millennium were just as tall, and had bones and teeth as good if not better than ours. We shrank and developed rickety bones in the middle ages and in the urbanisation of Georgian and Victorian Britain, and in the past few decades we have been simply catching up with those turnip-eating six-footers in the 9th century.

Yes, we have much longer life expectancy, but that is probably due to improved sanitation. Besides, there is the issue which we are only now beginning to consider, which is that life expectancy is a crude measure of health - quality of life is actually what we value. What is the point of living a few extra months if you are in complete agony? What is more, maybe our office-culture of long hours and high stress in polluted cities habituates us to a chronic state of tiredness, and anxiety - low-level ill health - which makes us vulnerable to the growing incidence of mental illness, cancer and heart disease. When the World Health Organisation claims that more resources will be devoted to depression than heart disease by 2020, it is clear that something has gone disastrously wrong.

The answer is obvious - we have to take on responsibility for our own health; if we lavished a fraction of the attention on maintaining our immune system that the British do on their gardens or their pets, we would all be glowing with good health. It is beginning to happen. The consumer mentality brings with it much higher expectations of what constitutes well-being. Alongside that is a growing recognition that conventional medicine cannot always deliver it. The explosion in complementary medicine is a revolution driven from below as people search out from ancient traditions, such as the Ayurvedic and Chinese, a more holistic approach. What is slowly developing is the democratisation of healthcare, as we take the initiative back from the western medical establishment and shop around the world for health tips. The internet will play a huge part: a quarter of everything on the net relates to health.