I am not sure whether this time last year anyone could have predicted what massive changes would have been wrought across commissioning in England – and not a single piece of legislation has been passed. We are moving from a dispersed form of governance, PCTs each with their own boards, with executive and non-executive directors, to a […]
Category: Columnists
Martin McShane: Mirror on the wall
Someone I know, who is not a health care professional but has dedicated most of their working life to supporting improvements in health and health care, recently shared with me their observations about general practice. Rather than focussing on poor performance they studied the good to find out what it was that made them different. […]
David Kerr: Street life
“Taking back the streets” has been a familiar call over recent days. The brief dominance of younger members of our society rampaging through the roads and alleyways across England recently has certainly caused a stir and much debate often using the analogy of a disease – thus far producing a great deal of heat but little […]
Julian Sheather: Living with your worst nightmare
Once in a while I make a mistake at work – in spite of my best intentions, the human will out. By and large though, people are little inconvenienced by my blunders. And where they are, and where I cannot put them right, I am usually happy to apologise. Taken in the right way there […]
Muir Gray: Competition between systems for pride is effective and essential
Is care for people with rheumatoid disease better in Liverpool or Manchester? Is care for frail elderly people better in Somerset or Devon? Which big city has the best service for people with bipolar disorder? […]
Douglas Noble on the riots
The recent riots in London and across the UK have been an awakening for many to realise the deep seated social problems in post modern British society. The right look for thugs to be prosecuted, while the left demand further description and analysis of the complex “causes of the causes.” Both approaches are polarised and neither […]
Richard Smith: Zero based healthcare
You may have heard of zero based budgeting where an organisation starts from the assumption that nothing that was in last year’s budget will automatically be in next year’s and instead starts with a blank sheet. It’s a good way to think what is really essential and what adds most value. My friend, Ian Morrison, […]
David Kerr: The dark side of insulin
It has been a strange few weeks for insulin. This year is the 90th anniversary of its discovery and in everyday clinical practice, insulin still remains “a force of magical activity” as described in a letter to the Times shortly after it was first used in humans. Nowadays, despite a bewildering array of therapies for […]
Richard Smith: UN meeting on non-communicable diseases goes wobbly
Things are not going well with the UN high level meeting on non-communicable diseases (NCDs) that will take place in New York in a month’s time. The aim was to have completed negotiations on the outcomes document before the UN closed for its summer break, but this wasn’t achieved. The member states causing the most […]
Tracey Koehlmoos: Institute of Medicine’s workshop on country level decision making for NCDs
In a previous blog I mentioned that I attended the Institute of Medicine’s workshop on country level decision making for control of chronic diseases, which was held on 19-21 July at the House of Sweden in Washington, DC. However, I had promised more details of the meeting and then promptly disappeared for two weeks of vacation […]