Richard Smith was the editor of The BMJ until 2004.
In most low and middle income countries the private sector accounts for 60-80% of outpatient care and 40-60% of inpatient care. Yet aid agencies have largely ignored the private sector, severely limiting their impact. This week a small meeting organised by the Centre for Global Development in Europe discussed how attitudes might be changed. Some […]
As I walked beside Clapham Common towards Trinity Hospice a famous BMJ phrase was ringing in my ears: “Hospice care is deluxe dying for the few looked after by dowager duchesses.” That may not be the actual quote, but the point was that hospices, funded mostly by charity, could provide an excellent death while most […]
My main job these days means thinking about non-communicable disease (NCD) in low and middle income countries (LMIC), but a paper in the Lancet suggests that I may be thinking in the wrong way. It’s always hard to shift your mental model dramatically, but perhaps I need to do so. I and the 11 centres […]
One of the questions that occurred to many after the public inquiry into Mid Staffordshire NHS Trust was “How could nurses and doctors behave like that and not do anything?” Similar thoughts arise after multiple examples of patients in care homes being abused and hover in the recurring questions of “Whatever happened to old fashioned […]
Health, says the WHO, is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity. But could it be that some sort of infirmity is essential for being healthy? […]
Lots of my friends have recently retired or are retiring. None of them, as far as I know, have been on preretirement courses. They launch into retirement, which may be very long, ill prepared, perhaps reflecting on stories of people quickly fading and dying after retirement. I have a proposal for them. I’ve not been […]
I was once in a restaurant in London when Nicole Kidman brushed past my table. Six feet of silver glamour. The effect was very much more intense than shaking hands with Prince Charles, meeting Tom Jones in a Paris hotel, or even watching Princess Diana at a garden party. Oddly I was reminded of Nicole […]
At Britain’s first and only summit meeting on research misconduct in 2000, Alexander McCall Smith, a professor of medical law and ethics, argued that research misconduct (the gentlemanly phrase for scientific fraud) should be a criminal offence. The idea seemed outrageous. Nobody took it seriously, but 13 years later Nature has published an editorial not […]
The Grand Convergence is the Big Idea of the Lancet Commission on Investing in Health. It is the idea that by 2035 the poor world could have similar mortality to the rich world. Is it achievable? Can it bring the “fractious global health community” together into one aim to replace the Millennium Development Goals? The […]
Simon Sebag Montefiore, the son of a doctor, recently argued that doctors make highly effective tyrants. Is he right and if he is why might it be? His article was not a systematic review but rather a brutal case study. The doctor tyrant of the moment is Bashar al-Assad. His regime has killed tens if […]