Commissioning of specialised services is done across the region. I had to drive to another county for the meeting where we were going to decide what to invest in. These are low volume high cost services currently costing about £600 million for our region. Historically it has had double digit inflation. That isn’t sustainable. […]
Category: Columnists
Richard Smith: We don’t know how best to communicate the benefits and harms of drugs
Every day hundreds of thousands of doctors and patients around the world discuss the benefits and risks of drugs. You might think therefore that we know how to communicate the information well, but the European Medicines Agency (EMA) and the Food and Drug Administration agree that we don’t. Indeed, the EMA logically thinks that before […]
Liz Wager: Something of rascality
At COPE (the Committee on Publication Ethics) we regularly receive cases of duplicate publication and undisclosed conflicts of interest. I was therefore intrigued to come across an accusation of publication misconduct in Boswell’s ‘Life of Johnson’ relating to the year 1769, which suggests such crimes have a long history. […]
Julian Sheather: Selling sickness to the worried well
I have an old friend with a long and complicated relationship with food. Several years ago she answered an ad in a woman’s magazine. She filled out a questionnaire, sent off a sizeable chunk of cash, and received back, on the basis of no discernible evidence whatsoever, a list of her likely food intolerances. Overnight […]
Richard Smith: Why is the health service so hopeless with domestic violence?
I’ve always thought that death, although universal, was the great taboo for health services, but now I’ve discovered something that seems to cause even greater difficulty for clinicians – domestic violence. […]
Martin McShane: Tick
In 2008 the National Patient Safety Agency set a deadline for acute trusts to implement the safer surgery checklist. By? Well, now actually. If you don’t know what the checklist is about it then read Atul Gawande’s latest book or a review of it. It would appear from a survey done by the Patient Safety […]
Richard Smith: Reducing chronic disease in Pakistan
Pakistan, like most developing countries, is experiencing rapidly rising rates of cardiovascular disease, diabetes, obesity, and chronic obstructive pulmonary disease, and it has developed a draft national plan for countering chronic disease. It’s an impressive and elaborate plan, as I discovered when I discussed the plan last week with people from the health ministry in […]
Richard Smith: The power of women in Pakistan
I’ve been in Pakistan teaching around 30 young women on the day that the Taliban has bombed a girls’ school in north west Pakistan killing three girls and injuring another 62. For the Taliban it’s a crime to educate women. For me the women I taught were an inspiration. The conventional view of women in […]
Julian Sheather: In praise of minor ailments
I have just been ill. Not very ill. Not ‘under the doctor’. Just a lingering cold, a touch of manflu. In the end I took a day off. I woke in the morning from an uneasy sleep and thought no, not today, today I’ll struggle no more. My wife took the children to school and […]
Liz Wager on stem cell scientists’ criticisms of peer review
Stem cell researchers from some major international institutions have written an open letter to journal editors complaining that they have received unreasonable and obstructive reviews (Euro Stem Cell) […]