Health, as we all know but are inclined to forget, is driven not by healthcare but by social determinants. But how do you produce social determinants that promote rather than undermine health? Political action is one way, but another is to strengthen communities. Jennifer Miller, chief executive of the Global Climate and Health Alliance, described […]
A 40 year old man has a cough—but his GP cannot find out the cause. Eventually the patient is referred to the local hospital where he is diagnosed with asthma. The doctor who sees him starts inhalers. But the inhalers don’t work and so he goes back for another appointment. The next doctor that he […]
Richard Smith visited and wrote about the NHS in Dumfries and Galloway in 1980, 1990, and 1999, and this series of blogs describes what he found in 2016. A feature article provides a summary. Accident and emergency is a pressure point in many hospitals with rising attendances leading to failure to meet the four-hour target […]
Richard Smith visited and wrote about the NHS in Dumfries and Galloway in 1980, 1990, and 1999, and this series of blogs describes what he found in 2016. A feature article provides a summary. The thing that currently pleases Angus Cameron, the medical director of the Dumfries and Galloway Health Board, is that the board […]
Richard Smith visited and wrote about the NHS in Dumfries and Galloway in 1980, 1990, and 1999, and this series of blogs describes what he found in 2016. A feature article provides a summary. England has an urban health system with some rural areas, whereas Scotland has a rural system with some urban areas, observes […]
There are many ways of discovering effective medicines. One can, for example, investigate herbal remedies, endogenous agents in animals and micro-organisms, or drug metabolites; use applied pharmacology and empirical chemistry; or implement rational design based on a target or pathophysiology. Not infrequently chance plays a part, as in the case of lithium. Two hundred years […]
Donald Trump has big pharma in the crosshairs. Using classic #TrumpSpeak, the soon to be 45th President of the United States hinted recently that Medicare, the biggest buyer of drugs in the US, could soon be able to negotiate drug prices directly with the pharmaceutical industry. This is something big pharma has spent years and […]
I squirm every time I hear that “increasing patient demand” is driving up costs in the NHS. I squirm because demand, although a standard technical word of economists, sounds so pejorative and blaming. “Those bloody patients. If they’d only stop demanding so much the NHS would be fine.” It’s crucial to understand (but is not […]
In their landmark paper in the British Journal of Cancer 45 years ago, Kerr, Wyllie, and Currie reported a phenomenon that they described as “controlled cell deletion”. They proposed calling it “apoptosis” and explained the term in a footnote, as follows: The word “apoptosis” (ἁπόπτωσισ) is used in Greek to describe the “dropping off” or […]
Theresa May is an unlikely revolutionary. Yet, on the day she entered 10 Downing Street, this was how she defined herself. She spoke of the need to tackle shorter life expectancy of those born poor, the harsher treatment of black people in the criminal justice system, and low educational attainment among white working class boys. […]