I’m back in London after spending nearly a year working in the national Children’s Hospital in Sierra Leone, West Africa, one of the poorest countries in the world. It has been amazing to come back to the luxuries of reliable water and power, safe and efficient transport, and a seemingly unlimited procession of utterly […]
Beth Cherryman: A graduate tax
Business secretary Vince Cable has proposed a “graduate tax” as a solution to university funding. Graduates will be taxed according to some percentage of their income (once earning over £15,000 a year). In this system higher earners will pay more tax. Cable argues this is a fairer option than that employed currently, in which, after […]
Julian Sheather on public health: complex problems, simple truths – the case of Sebastian Kneipp
Near universal consensus then that we are in the grip of a public health disaster. Daily the evidence mounts: obesity, smoking, alcohol abuse, our very lives are killing us. And how insurmountable the problems seem, how high the hurdles. Massive corporations – the food, tobacco and drinks manufacturers – are ranged against us, saturating our […]
Richard Smith: Can you ask a patient anything?
Can a doctor ask a patient anything? In the Netherlands the answer seems to be “yes.” Doctors tend not to think so, but at a meeting between doctors and patients in the Netherlands the doctors found that the questions they thought impossible to ask, the patients were happy to answer. Unfortunately the meeting wasn’t written […]
Chris Ham on GP commissioning
In a recent speech to the BMA, Andrew Lansley argued that separating the management of care from the management of resources was a fundamental weakness, adding “examples in America of physician-led, more integrated services, demonstrate how differently – and effectively – they can deliver care.” As someone who has studied integrated delivery systems in the […]
Richard Lehman’s journal blog, 19 July 2010
JAMA 14 July 2010 Vol 304 163 The classic hero of palliative care used to be the personal doctor who turned up in the middle of the night to administer symptom relief and consolation. Most doctors have done that from time to time, and found it immensely satisfying and immensely tiring. So what, by contrast, […]
James Clark on health provision for asylum seekers
The person I was speaking to turned to me with tears in her eyes and whispered, in her broken English: “I’m scared. I been scared for so long.” I had never counted myself among those who read the Daily Mail, but knew so little about asylum seekers that my views had long been distorted by […]
David Payne on Raoul Moat and Desert Island Discs
The sorry saga of fugitive gunman Raoul Moat has no doubt triggered countless watercooler conversations about the extent to which he was “mad, bad, or just plain evil.” A colleague described him as less of a threat than the media painted him on the grounds that all of the people he killed or maimed were […]
Edward Davies: The NHS white paper (entirely predictable and not very radical)
Two of the major charges being thrown at this week’s health white paper have been that it is completely unexpected and brain-meltingly radical. On the first point I’ve already had dozens of conversations with people who just “didn’t see this coming.” David Aaronovitch wrote in yesterday’s Times that there was little point in manifestos if […]
Richard Smith on doctors’ tricky decisions
One of the pleasures of being a doctor, albeit one who doesn’t see patients, is that you get to chat to other doctors, real ones, about the tricky decisions they have to make. I’ve had two such sets of conversations in the past week that have stuck in my mind. […]