Years ago, I stumbled across Roald Dahl’s macabre short stories whilst looking for tales of chocolate factories and witches’ conferences. In one of the most famous stories, William and Mary, a terminally ill husband, William, consents to a gruesome experiment upon his death. He lets a neurosurgeon keep his brain and an eye alive in […]
James Raftery: Moving to value based pricing—adjusting costs
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 […]
Kailash Chand on the NHS commissioning board
In the Department of Health’s guidance Developing the NHS Commissioning Board, David Nicholson stated: “CCGs (Clinical Commissioning Groups) will be the engine of the new system and things will only be done at a different level of the system where there is evidence that this produces better results.” However, there is wide spread concern that […]
Richard Smith: Why I should become a lobbyist
“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 […]
Julian Sheather: Medical electives—laying the ghosts of empire?
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 […]
Richard Lehman’s journal review—19 November 2012
JAMA 14 Nov 2012 Vol 308 1916 Last week we learned that male doctors who were randomised to take a daily multivitamin preparation had cardiovascular events and died from them at exactly the same rate as those who took placebo for a median of 11.2 years. This week we learn that they also died of […]
Katy Cooper: NCDs, MDGs, SDGs – a crowded space explained
Since the United Nations (UN) high-level Meeting on non-communicable diseases (NCDs) in September 2011 things have got busy—and potentially confusing. Running in parallel to the establishment of a new “global framework for NCDs” are negotiations at UN and World Health Organization (WHO) level on what will replace the Millennium Development Goals (which are due to […]
Richard Smith: Monkeys help explain why poor people are fatter
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 […]
Rob Hampton: Long term absence needs to be case managed
At the end of November the government will give its response to last year’s sickness absence review led by business leader David Frost and healthcare expert Dame Carol Black. A key recommendation of the review was the establishment of an independent assessment service (IAS), to which GPs could refer patients who have been off work […]
Muir Gray: Setting standards for systems of care
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 […]