Almost unnoticed by medical schools and health systems the nature of health care has changed radically. The traditional medical model is “patient admitted, diagnosed, treated, cured, sent home,” and the special role of doctors, said one chief medical officer recently, is “diagnosis, diagnosis, diagnosis.” In reality there is little diagnosis and even less curing. Most […]
“If a minister from England asked you about breaking the English NHS into regions, what would you say?” I asked this of a senior official in the Andalucian ministry of health. “Break it up. No question. You can’t manage a system for more than 10 million people well.” Spain has made this transition. In the […]
The coalition programme for government states: “We will create a cancer drugs fund to enable patients to access the cancer drugs their doctors think will help them, paid for using money saved by the NHS through our pledge to stop the rise in national insurance contributions from April 2011,” and “We will reform NICE and […]
Asked his opinion on the political issues of the day, Saul Bellow, the American novelist, would sometimes say that he was in favour of all the good things and opposed to all the bad ones. Bellow’s lovely little quip has been on my mind a good deal of late. […]
My wife hates walking. For her it means trudging through the rain and mist, cold, exhausted, wet to her underwear, and with five miles still to go to a smelly bed and breakfast. It can be exactly that, but for me walking 15 miles day after day is one of life’ s greatest pleasures. […]
When the little woman in red arrived at the dissemination seminar of the Urban Partnerships for Poverty Reduction Programme (UPPR), I was dually impressed by her small size and that she bought her toddler with her. Although my three sons consume most of my time and effort outside of work, I’ve never been to a business meeting where someone […]
I recall when I first attended a medical science teaching committee meeting at St Andrews University in 1995. I was overawed by the complexity of running a medical curriculum, bringing all the academics on board, and agreeing teaching plans. I was there because someone thought it was a good idea to have a student in […]
I was at a conference, struggling with one of those sharp sticks on which a bit of chicken was impaled whilst holding a plate of food in the other hand, when I noticed a short, bald bloke checking out the conference buffet. It was Greg Dyke. He had come to talk to about 250 managers […]
I am a terrible coward. I flee pain as the gazelle flees the lion. On a bad day I am living proof of Jeremy Bentham’s universal dictum: that the sole motive of a human being is to avoid pain and achieve pleasure. For this reason alone I am a champion of medicine. If I am […]
At the end of my class on leadership at Warwick Medical School comes a dreadful moment. I’ve enjoyed myself and am packing up, when the only student left, a woman, says to me “Why were no women leaders mentioned?” I don’t panic, but I at once recognise that we’ve discussed many male leaders and not […]