I’ve been thinking a lot recently about MPs doubling as ministers of state politically responsible for key public services. What are the characteristics of a good or bad one? I’ll start by saying upfront that while I understand the need for democratic accountability and oversight for large amounts of public money, even the system we […]
Fionnuala Finnerty: Lessons must be learned from the Calais “jungle” camp
Protection against sexual and gender based violence is imperative in the current refugee crisis Last autumn, I began to volunteer in the Calais “jungle” camp with the Hummingbird medical project in a weekend first aid clinic. Travelling by Eurotunnel, it took less than three hours from my comfortable home in Brighton to arrive at a […]
William Cayley: Will mid-level practitioners replace primary care physicians?
I recently asked whether, in light of the relative drop in the number of trainees entering family medicine in the US compared to other specialties, we can continue to find ways to bolster the strengths of primary care, both in medical education and practice—since we know that primary care “helps prevent illness and death.” Some […]
Junior doctors’ strike 6 – 8 April 2016: Live blog
The latest round of strike action from junior doctors in England is taking place this week. In a similar vein to the action taken last month, junior doctors will be offering emergency care only for 48 hours between 8am on Wednesday 6 April and 8am on Friday 8 April. The BMJ will once again be charting events as […]
Peter Lees: “The doctors’ mess is dead, long live the doctors’ mess”
I regret not fighting harder for the maintenance of the doctors’ mess. Sure we fought tooth and nail in the late seventies and early eighties when we perceived that the administration (as it was then called) had its eyes on our central prime real estate. We always won because we were united, we valued the […]
Richard Smith: Coaching—an essential skill in modern health practice
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 […]
What are the consequences of recent caps on NHS agency staff spending?
Four months since the first caps on agency spending were introduced by NHS Improvement—and after new framework agreements came into force last week—what do we know about the impact of these measures so far? Unfortunately, not a huge amount. Although NHS providers are submitting weekly data returns to NHS Improvement, no official figures have yet been published. Without […]
Richard Lehman’s journal review—4 April 2016
NEJM 31 Mar 2016 Vol 374 Going Dutch with Lyme 1209 When you open a journal with New England in its name and read about Lyme disease, you somehow don’t expect the study to have been carried out in the Netherlands. But never mind: it’s a good study and the investigators managed to collect enough […]
Canada’s First Nations: The social and political determinants of health
To what extent are the social determinants of health (SDH) political determinants, and which of these are the most amenable to policy reversals that will increase or decrease inequalities? Reviewing the actions of the conservative government under Prime Minister Stephen Harper (2006-15), together with early initiatives taken by the just elected Prime Minister Justin Trudeau, […]
Yogesh Jain: Hippocratic crime
Last month police in India arrested Saibal Jana, a doctor with 35 years’ experience caring for patients from indigenous and other marginalised rural communities. The arrest was made on the grounds that he absconded by not attending hearings for a court case filed 24 years ago. The case involved 52 people implicated in an agitation for […]