Through all the changing fashions in donor attention, Save the Children has always pointed out that building a functioning health system must be the basis of development work. Then it does not matter if a condition or a health threat facing a community is HIV, maternal mortality, malaria, (which have attention from donors) elephantiasis, chagas, or river blindness […]
Domhnall MacAuley: Comprehensivists vs partialists at NAPCRG
Innovative primary care pilot programmes are big news in the US. Money talks, and from a business perspective, primary care is good value. So good, that Paul Grundy’s (US) company IBM provides free primary care to its employees and incentivises referral strategies. Rebranded as the advanced medical home in the US, his model of personal and […]
Martin McShane: Gentlemen or players (and fish farms)
The concerns expressed by the new chair of the RCGP about the difficulties which GPs might face, in taking on commissioning, are pertinent. There is always a tension between being the advocate for the patient in front of you and for the population behind them. It does seem odd that PCTs have been exhorted to divorce […]
Edward Davies: Who’d be an NHS manager?
I’ve just come back from the NHS Employers annual conference in Liverpool. As one of the biggest gatherings of HR managers in the country it’s very easy to mock, so that’s exactly what I intend to do. […]
Richard Lehman’s journal review – 22 November 2010
JAMA 17 Nov 2010 Vol 304 Like all doctors who survived their hospital jobs in the 1970s, I have some shocking memories. Oddly enough, though, some of them are happy too, as the shocks saved lives. The woman dragged out of a freezing canal with a core temperature of 28ºC who survived intact after 16 […]
Harriet Vickers: Lessons from “Bloodgate”
What do the conductor of the London Mozart players, a Michelin-starred chef, the surgeon who treated the survivors of an Everest disaster, a leading UK barrister and Max Clifford have in common? Superficially, not much. However this week the Risky Business conference brought these people, among many equally varied others, to speak to healthcare professionals […]
Sarah Jacobs on cholera in Haiti
I’ve never thought that much about water. I’m vaguely aware I should drink more of it. But that’s about it. Like most people who have the luxury, I take it entirely for granted. In Haiti everybody is thinking about water. All the time. Water here has suddenly started killing people. And it’s everywhere. Bucketing down […]
Research highlights – 19 November 2010
“Research highlights” is a weekly round-up of research papers appearing in the print BMJ. We start off with this week’s research questions, before providing more detail on some individual research papers and accompanying articles. […]
David Nicholl: So what happened to Jannett?
Jannett is my patient, who I have been following up since last year when she presented with Lambert Eaton myasthenic syndrome. The diagnosis was not straightforward, but then neither has her management. Around May, I realised that the treatment she was on, unlicensed 3,4- diaminopyridine, was due to be withdrawn due to the price hike […]
David Payne: Safe planes and the night handover
Patient safety conference organisers are fond of the analogy between aviation and medicine. Former F18 pilot Steve Kreister addressed delegates attending the paediatrics day of Risky Business 2010 in London yesterday afternoon. Airline pilot Martin Bromiley – founder of the Independent Clinical Human Factors Advisory Group (CHFG) – addressed BMJ Group’s Agents for Change conference […]