I took my A levels in the 1970s before all this dumbing down crap. I can still take them to the bank and use them as collateral because everyone knew that a quartet of passes in the days before Punk meant that you had a real grasp of your subjects. If current trends persist, in five years’ time everyone who turns up for the exam on time will pass. But it isn’t only in the world of education where the goalposts are moving.
Strange things are happening in the world of medicine, too. I learnt about diabetes in the 1980s — an absolute or relative lack of the hormone insulin resulting in an inability to maintain an ideal blood-sugar level. Nothing complicated about that. Stick some bovine or porcine insulin, which was a near enough match, into the punter twice daily to compensate and that was the job done. It’s more complicated now, with huge vats of genetically modified bacteria pumping out analogues of human insulin and patients varying their insulin doses hourly.
This seems to be so much fun that people just can’t wait to jump on to the bandwagon.
In the 1990s we learnt the “rule of halves” — there were thought to be one, maybe two diabetics in every 100 adults. In half of them diabetes would be undiagnosed and only half of those identified as sufferers would be receiving adequate medical care. So there was room for improvement.
But, what to do once we’d found all the existing diabetics? Doctors aren’t famed for sitting around on their backsides doing nothing.
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Back then you had to work pretty hard for your illness to get diagnosed. You had to tell someone that you were thirsty all the time and bothered by frequent trips to pass urine. You might even mention that you were losing weight. Real attention seekers made their point by lapsing into a coma. Then, and only then, could you consider yourself “ill”.
At about the same time that A-level results started to improve so dramatically that even the pupils taking them began to feel cheated, the diagnostic criteria for diabetes changed. From June 2000 the World Health Organisation decreed that the cut-off level for a diagnosis would drop overnight from 7.8 blobs of glucose per litre of plasma to just 7.
A 10 per cent reduction in the qualifying standard might not sound like much, but the real-life effect was astounding. Instead of blacking out in Tesco and waking up to see a nurse preparing to force-feed you Lucozade, all you had to do in the brave new world was to have a blood test within a week of eating a Mars bar.
Then you get to label yourself as a “patient” rather than a person and are frogmarched to an optician, a dietitian, a chiropodist and your GP’s practice nurse twice a year. You also get targets for your cholesterol, your blood pressure and your blood sugar, and you get pills to take every day to keep all three under control.
Four years on we now have 1.4 million diagnosed diabetes sufferers in the UK and naturally still think that we’ve found only half of the total. I’m in my forties with a 37in waistline, which in some experts’ eyes puts me in the “at risk” group not only for diabetes but also for coronary artery disease. I’d point out that at well over 6ft tall, the only group I’m in that matters is the “too tall to buy trousers at Marks & Spencer” cohort. Which, actually, really pisses me off.
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Dr Copperfield is an Essex GP. He also writes for Doctor magazine