“There is no kingdom too small for a doctor to be king of,” is one of my favourite sayings. Last week at a workshop for patient organisations organised by the Medtronic Foundation I learnt that it may be even more true for patient organisations. I’m a big supporter of patient organisations. They do an important […]
With the introduction of value based pricing scheduled to apply to new drugs when the current prescription pricing regulation system expires in 2014, the Department of Health has been working on the details of how it might apply. This blog reports on an invited workshop held by NICE on how the cost impact of health […]
“I’ve been lobbied. I am a lobbyist. Lobbying is not a dirty word. It’s a fundamental part of the political process. You should be a lobbyist.” This is how David Bowe, a former Member of the European Parliament and now a professional lobbyist, opened his talk at the Medtronic’s Foundation workshop in Brussels on patient […]
I was at Brighton Medical School recently, talking ethics to third years, and a lively and engaging bunch they were too. Among the many things we talked about were electives, particularly in resource poor countries. It is no surprise that students look forward to their electives. The travel appeals of course; the ability also to […]
Within all human hierarchies those lower in the hierarchy have poorer health than those higher up. In high income countries poor people are fatter than rich people, and, although the gradient did initially go the other way in low income countries, it’s now true in them as well. But why? Monkeys can help answer this […]
Read the rest of this series of blogs about designing and planning population based systems of care here. Step 5: Setting standards Having formulated objectives and chosen criteria to measure those objectives, the next stage in the development of a system is to set standards. (Standards can be set for process criteria even in the […]
One of the conclusions of Ben Goldacre’s important book Bad Pharma is that our current system of publishing science is broken. More and more people are reaching that conclusion, and pressure is building to blow apart the present system. Goldacre’s prime concerns are not only that many drug trials are not published, but also that […]
The publication of a summary of the benefits and harms of breast cancer screening in the Lancet, with the full report to follow, raises the question of whether referring this to NICE would have made any difference. The most obvious difference is that NICE would have gone on to appraise cost effectiveness. The final sentence […]
One of the hottest topics in Irish medical politics finally came to a head this week with the announcement of the location of the new national childrens’ hospital, amalgamating the three Dublin paediatric hospitals on the site of an adult hospital. For the host institution, this was a step of the utmost importance, as its […]
Post partum haemorrhage (PPH) is one of the leading causes of maternal deaths. According to WHO estimates, in 2010 there were 287,000 maternal deaths, 25% of which were associated with PPH. The risk of PPH is greatest in anaemic women and the risk of PPH resulting in death is greatest in settings where there is […]