…and I wonder how much this will be costing in expenses. The Coalition is launching a ‘listening exercise‘ into their reforms of the NHS, staffed mainly by management and academics. But have they not already being paying attention? What more do they want? We have already heard from the Chair of the RCGP (who is […]
Continue Reading →Everyone should read this
Allyson Pollack and David Price in the BMJ. How the secretary of state for health proposes to abolish the NHS in England
Continue Reading →What’s happening to the National Confidential Inquiry into maternal and perinatal deaths?
For the last 50 years, every maternal and perinatal death has been independantly and carefully scrutinised. This audit is world-class: it has spotted problems, made recommendations, and raised the standard of maternity care for everyone. Not every speciality has this gold standard of examination: were that we did. The BMJ reports this week that the […]
Continue Reading →Commissioning is bad for patients
I don’t know what the point is of getting rid of one layer or managers (in PCTs) only to replace them with doctors – how many hours have GPs already spent on commissioning palava in England? Whenever the NHS and politicians interact there is a consistent problem. No one ever values the core aspects of […]
Continue Reading →Shared decision making
Podcast recorded at BMA House last week. I hope they have edited out my slightly bad language.
Continue Reading →Prostate cancer screening: how will this be reported?
I’d love to do a study of column inches of negative trials versus positive ones. This Swedish study in the BMJ, published on the 31st March, found that over 20 years of screening, in almost 1500 men, there was no change in death rate from prostate cancer whether you had prostate cancer screening or not. As […]
Continue Reading →Preventative measures for breast cancer, and how we view risk
The Lancet has run a Consensus Statement about preventing breast cancer. They say “Many risk factors have been established for breast cancer, the most informative of which are family history of the disease, especially at a young age, increased mammographic breast density, some menstrual and reproductive factors, and proliferative benign disease. Various models have been […]
Continue Reading →What medical intuition/sixth sense really is
rapid Bayesian reasoning. at least, I think so. Very interesting talk last night by John Gillies, chair of RCGP Scotland. of which more later.
Continue Reading →“Consent rituals”, meaningful decision making, and ethics
Gerd Gigerenzer and Muir Gray’s new book is out: Better Doctors, Better Patients, Better Decisions. The message is that patients have to be involved in making decisions about their health, and I couldn’t disagree. As Gigerenzer (one of my heroes) has pointed out in Reckoning with Risk, the numbers we base our decisions on, however, […]
Continue Reading →Panic about nuclear apocalypse overshadows Japan’s real plight
Article in the BMJ, toll free link, here.
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