“The NHS is under tremendous pressure,” I tell a novelist friend. “Could it die?” he asks. “I suppose it could.” “How would that happen?” How would it happen? That’s a hard question. I didn’t have a convincing answer, but it’s a question worth examining. I trotted out to my novelist friend my usual reference by […]
When the National Health and Medical Research Council report on homeopathy concluded that “There was no reliable evidence from research in humans that homeopathy was effective for treating the range of health conditions considered” few in conventional medicine were surprised, but the homeopathy community were outraged. As chair of the working party which produced the […]
I’ve become somewhat of a Quality Improvement #QI geek in the last year or so. Since first getting my head around the concept, I’m now an enthusiast and have witnessed first hand how useful it is as an approach to improve services and the quality of what we do. I still firmly believe it takes […]
The H in NHS stands not for hospital or healthcare but health, and the NHS needs to do better at promoting health, said Simon Stevens, chief executive of NHS England, this week at a meeting organised by the University of Southampton. If England can’t do better at prevention then the NHS will be overwhelmed, said […]
Today, 12 February, is the 75th anniversary of the first clinical use of penicillin in Oxford in 1941 (picture). Image: A plaque commemorating the first administration of purified penicillin to a patient in the Radcliffe Infirmary on 12 February 1941 by Dr Charles Fletcher; the word “systematic” is not necessarily an error; the word has occasionally, […]
One of the greatest challenges for us as we age is “bar stool gerontology.” For most complex subjects—nuclear physics, molecular biology, or philosophy—most of us recognise that some learning and education are required to grasp their fundamentals. Yet despite the fact that we are at our most complex in later life, it remains acceptable in […]
In my 40 years of messing around with medical journals I’ve tried to contribute to promoting patient safety and the use of evidence. Generally things seem better from a time when patient safety was largely ignored and evidence used haphazardly rather than systematically, but I fret now that doctors are using both safety and evidence […]
Words that sound wonderful can come back to haunt you. As a case in point, I recently responded to Elizabeth Wortley’s eloquent blog “Please refrain from using that kind of language” with the question: What if we decided to try to become “experts” in treating the difficult (patients)? That sounds great in a conversation, but those […]
As I have previously described, delaying tactics in a conflict are known as Fabian tactics, after Quintus Fabius Maximus, who used them against Hannibal’s Carthaginians during the Second Punic War, and earned the nickname Cunctator, the Delayer. The dispute between the government and the junior hospital doctors drags on, and Jeremy Hunt/Cunctator seems to be […]
Parliament has three times relegislated the commissioner provider split—in 1990, 2002, and 2012, said Stephen Dorrell, secretary of state for health from 1995-97, in a talk to the Imperial College Centre for Health Policy this week. Every health secretary for the past 26 years—with the exception of Frank Dobson—has believed in commissioning. But, he asked, […]