Decades after it was introduced, the impact of fundholding still resonates. Many GPs hanker after the influence it brought, the way it made the big providers in the system sit up and take notice of primary care. My own experience, as a GP at the time, was one of quality improvement. Suddenly, we could directly […]
Category: Columnists
Julian Sheather: Should we pay drug addicts to be sterilised?
Barbara Harris is a concerned American. After adopting four children from a crack-addicted mother, she tried to change the law in California. She wanted to make it mandatory for every mother giving birth to a drug-addicted child to use long term birth control. When the Bill failed Barbara Harris set up the charity ‘Project Prevention’. […]
Richard Smith: Five examples of scaling up
Developing interventions that work to, say, reduce malaria, combat obesity, or prevent cardiovascular disease is hard, but scaling them up to benefit whole populations is harder. Yet the interventions must be scaled up to make any important difference to global problems like malaria, obesity, and cardiovascular disease. The Oxford Health Alliance meeting in Delhi last […]
Richard Smith on Matlab, Bangladesh
The cholera hospital in Matlab, Bangladesh, has patients in the corridors and every nook and cranny, but as we walk through the mood is calm. Most beds have two people, usually a mother and child. The mood may be calm because acute, watery diarrhoea is part of life in Bangladesh, and the parents and patients […]
Julian Sheather: Whose potbelly is it anyway?
I have just been to a lecture – whose title I’ve stolen for this blog – given by Inez de Beaufort, Professor of Healthcare Ethics at the Erasmus Medical Centre in Rotterdam. Subtitled ‘Ethics, obesity and public health’, and organised by the Nuffield Council on Bioethics. […]
Richard Smith: the unrecognised epidemic
About 200 million adults a year undergo major surgery that is not cardiac surgery, and about 5 million of those people suffer a major vascular complication. That, said P J Devereaux from McMaster University at the Oxford Health Alliance meeting in Delhi last week, is about the same as the number of people contracting HIV each […]
Richard Smith: A day in village India
“The village is the real India,” said an Indian friend, echoing Gandhi and the continuing belief of many Indian intellectuals. “What is the village but a sink of localism, a den of ignorance, narrow mindedness, and communalism [putting your own ethnic group ahead of society],” said Bhimrao Ambedkar, who drafted the Indian constitution and was the […]
Siddhartha Yadav: Sexual and reproductive health of adolescents in South Asia
Last week I participated in the “Adolescent Sexual and Reproductive Health Workshop” organised by the International Federation of Gynecology and Obstetrics (FIGO) in Bangalore, India. We had gathered there to formulate a set of guidelines and protocols for adolescent reproductive health services specific to Asia. […]
Richard Smith: Anna’s legacy
“Anna [Donald] has left a remarkable legacy to other patients like myself with advanced disease,” says Helen Owens, a patient with cancer, on the website Anna’s Adventure. Anna Donald, as many BMJ readers know, was a doctor, Rhode’s Scholar, and one of the founders of evidence based medicine who died of breast cancer last year […]
Tracey Koehlmoos: Meeting the Marlboro man in Jakarta
Last week my three boys and I were visiting friends on our first trip to Indonesia. Jakarta is enchanting…shiny, modern, glossy, and brimming with cultural charm: twisty roads, unique architecture, flamboyant flora, and great food. […]