“I switched over to vaping but someone told me they were just as bad as cigarettes so I went back to smoking again.” A depressing thing to hear in a COPD clinic, but unfortunately not that uncommon. Worryingly, the proportion of the population with the erroneous belief that vaping is as hazardous as, or more […]
A youthful Christine Keeler sits in custody refusing to answer questions, cigarette in hand. Season 2 of Netflix’s The Crown, culminates with the Profumo affair. It is 1963, six years after The Medical Research Council had published a statement announcing “a direct causal connection” between smoking and lung cancer, and that scene sadly foreshadows Keeler’s […]
Andrew Lansley had his calamitous Health and Social Care Act 2012; Kenneth Clarke introduced the wasteful and destructive NHS internal market before going off to work for British American Tobacco; Enoch Powell was a racist. This does make it a challenge for Jeremy Hunt to podium in the grim competition to be the country’s worst […]
Winter is here and with it the annual NHS winter crisis. Lung disease makes a substantial contribution to this, particularly in children and older people. Many respiratory illnesses are seasonal; cold weather, damp homes, and the increased circulation of viruses cause a winter spike in conditions including flu, COPD exacerbations and bronchiolitis. There are 80% […]
It’s indisputable that privatisation is occurring in the NHS, so where does privatisation denial come from? […]
The recognition of a new clinical entity, “chronic breathlessness syndrome” has been proposed, following an international Delphi process to achieve an expert consensus.1 Why does this matter and is it a useful idea? Breathlessness on exertion is a feature of a normal healthy life, but undue breathlessness is also a common symptom, affecting around 10% […]
Decisions about healthcare inevitably involve choices around the allocation of finite resources. Democracy, if it is meaningful, is public reasoning. The National Institute for Health and Clinical Excellence (NICE), established by Frank Dobson in 1999, though imperfect, represents a worthy attempt to conduct a reasoned assessment of what a decent health service should provide. When […]
It is no secret that the UK healthcare system is under strain. The percentage of GDP spent on healthcare is projected to fall to 6.6% by 2020/21, back to the same levels as the 1990s. For comparison, the OECD average (excluding the US) is 9.1%. Reminiscent of the 1990s, waiting times are rising and the system […]
How should a European clinical academic react to the fact that the US election appears to have sent a racist, misogynist, climate change denier to the White House? One response, arising in the context of President Trump’s ban on people from seven predominantly Muslim countries entering the US, has been a call to boycott US […]
One explanation that has been offered for the UK’s self-destructive decision to leave the European Union is that there are now few people left alive who can remember the ruined Europe after the Second World War. Last year saw the 60th anniversary of the Clean Air Act, but it seems that the great smogs and […]