Richard Smith was the editor of The BMJ until 2004.
When the NHS began in 1948 dental care was free at the point of delivery, but charges appeared as early as 1951. My current experience with dental services gives me a foretaste of how the whole NHS may begin to crumble. There is little left of one of my upper molars. My NHS dentist has […]
Uganda, like all low income countries, has formidable health problems and limited resources. If you were the health minister in Uganda what would be your priorities? This question was in the back of my mind as I listened to the presentations at the Uganda Health Summit held in BMA House and organised by the Uganda […]
I’m on my way to walk among bluebells, but my mind is on junior doctors engaging in a total strike, not providing even emergency care, for the first time in the 68 year history of the NHS. How did it come to this? I feel that as “a sort of Doctor” for 40 years and […]
Ask somebody “What is the NHS?” and they are likely to answer to “The people who work in it, the buildings they work in, and the tools they use to do their work.” But it clearly isn’t that. The people who work in the NHS come and go, and none were working in the NHS […]
Last week I gave a talk to the International Society of Medical Publication Professionals entitled “Medical journals: time for something different.” My core argument was that “Medical journals have played an important role in spreading medical knowledge, but they are now beset with problems. Some will transform, most will disappear. New forms of disseminating medical […]
The commonest undergraduate degree of students entering the medical school at University of California Irvine is philosophy. The medical school, traditionally the richest and most arrogant of university departments, has at UC Irvine reached out to the philosophy department for help. At a conference there last month I met a student who is simultaneously studying […]
If you have meningitis how well you do depends on the medical team, whereas if you have diabetes it depends mainly on you, the patient. These days most of healthcare is about patients with long term conditions, usually multiple conditions. So the old style of healthcare when sick patients could be rapidly cured, which many […]
Jeremy Hunt, secretary of state for health, is embroiled in battles with junior doctors, GPs, and consultants over contracts and patient safety. He thinks that he will improve safety by reducing excess weekend deaths. The doctors think that he’s endangering patient safety through obliging them to work unsafely. Ironically, he’s the first secretary of state […]
The Care Quality Commission has placed 27 health institutions, most of them hospitals, into “special measures,” and so far 11 have emerged. Few jobs can be tougher or lonelier than taking over the leadership of a failing hospital. Regulators may put you under tremendous pressure for quick results, while staff may hope to “see you […]
Earlier this week the Canadian Medical Association fired the editor of the CMAJ and dissolved the journal’s oversight committee, which was supposed to protect editorial independence. While doing so, the board of the CMA—with impressive hypocrisy—reaffirmed its commitment to editorial independence. That’s two editors the CMA has fired and two it has “let go” in the past […]