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Chris​ Simms: Deracination—Canada’s aboriginal suicides

29 Apr, 16 | by BMJ

Chris_simsFour aboriginal boys, two aged 8 and two aged 9, bolted midday from their school, half-clad, mid-winter, to make the 12 mile trek to their families in Nautley Reserve. When they were found the next day in the slush-ice on Lake Fraser less than a mile from home—arms wrapped around one another in a frozen embrace—few could have guessed the circumstances.

When, 80 years later, the community of Attawapiskat (population 2000) declared a state of emergency on 9 April 2016, reporting 11 attempted suicides in one day (and 100 attempts over the winter), Canadians may have been shocked, yet few would have been surprised. Several pieces of evidence including audio and video clips explain why.

Both events trace back to the federal government’s paradoxical policies of marginalization and assimilation. more…

Suzanne Gordon: The future of the Veteran’s Health Administration

29 Apr, 16 | by BMJ

suzanne_gordonBy the end of this year, the US will have a new president as well some new members of Congress. The results of the 2016 election will not only effect the further implementation of the Affordable Care Act (Obamacare), but the future of the country’s largest healthcare system—the Veteran’s Health Administration. That’s because most of the Conservative Republicans running for President—as well as many of those running for or already serving in Congress—are not only determined to repeal Obamacare. They are also committed to dismantling the largest and only publicly funded, fully integrated healthcare system in the US—the Veterans Health Administration (VHA). Even many Democrats are not fully supportive of the VHA. While Hilary Clinton says she does not support privatization of the VHA, only Bernie Sanders (D. VT) has demonstrated a deep understanding of what the VHA does and how it actually works. more…

Vickie Hawkins: “Your enemy’s doctor is not your enemy. Hospitals are not targets”

29 Apr, 16 | by BMJ

Vickie Hawkins, Executive Director MSF UKLate on Wednesday night two barrel bombs fell on buildings surrounding the hospital of Al Quds hospital in Aleppo, Northern Syria. As tens of wounded were being rushed to the emergency room (ER) for treatment, a third barrel bomb fell directly at the entrance to the ER, killing and injuring staff and patients. The building was immediately reduced to rubble while surviving patients, staff, and volunteers began to search desperately for those caught in the ruins.

At least 14 people lost their lives, including two doctors, two nurses, a guard and a maintenance officer. The remaining eight were patients. more…

Jeffrey Aronson: When I use a word . . . Weasel words

29 Apr, 16 | by BMJ

jeffrey_aronsonIt has been reported that Department of Health lawyers have said that the secretary of state for health, known to us as the SoSH or the Cunctator, never intended to “impose” a contract on the junior hospital doctors, only that the contract would be “introduced” from August (as quoted in the Independent on 18 April).

“Impose” comes from the Latin verb ponere, to place, set, or put, in various senses. Imponere meant to place, put, or lay on, in, or over. However, it also carried a connotation of authority, and because it could mean to put someone in command it also came to mean to lay on as something to be borne and therefore to force something, such as a tax or a punishment, on someone. These and other meanings entered English in the 16th century. more…

Kawaldip Sehmi: The patient-centred approach of the Hillsborough inquest

29 Apr, 16 | by BMJ

Kawaldip SehmiRespecting the families’ euphoria and personal grief, I delayed this blog post on the Hillsborough inquest verdicts (the verdict came at lunchtime 26 April 2016). Let them savour their day in court, and well done to all on the Justice For The 96 campaign, especially Michael Mansfield QC, who has now got into a bit of a habit of shaking the conscience of our society and our complacency about our state agencies.  more…

Thomas Macaulay: Senior doctors’ opinions on the junior doctors’ strike

29 Apr, 16 | by BMJ

tom_maccauleyThe letters pages of British broadcasts last week were inundated with the views of doctors on the strike of their junior colleagues.

Most were united in their criticism of the misleading media coverage. Writing to The Guardian, Dr Michael Maier described the reporting as “sensational and inaccurate” with particular reproval reserved for the description of a 48 hour withdrawal of emergency care that was “actually between the hours of 8am and 5pm on 26 and 27 April.” more…

David Oliver: Are we recreating the conditions that led to the Mid Staffs scandal and Francis inquiries?

28 Apr, 16 | by BMJ

david_oliver_2015I am worried that we are heading right back to the very conditions that led to the Francis inquiries, losing any progress we have gained on the back of them. In health, as in many industries, it often takes a major incident or scandal to prevent more from occurring in the future. But let’s not go back to it.

It’s now six years since the report of the independent inquiry by Robert Francis QC into events at Mid Staffordshire NHS Foundation Trust from 2005-9. It’s still a powerful testimony of a hospital whose culture was broken. more…

Joseph O’Keeffe: The junior doctors’ strike—voices from the ward

28 Apr, 16 | by BMJ

joseph_okeeffeJunior doctors are arguing that the contract changes compromise patient safety. I agree. But do those we treat? It’s hard to tell. Social media appears dominated by the junior doctors, whereas the newspapers and the broadcasters merely present a succession of politicians and “experts.” The patient’s voice seems lost amidst the acrimony between the Department of Health and the BMA, especially that of some of our most poorly patients: the elderly. The official polls focus on getting nationally representative surveys, lumping our older patients into a “60+” category. As any healthcare worker knows, there’s a stark generational difference between patients in their 60s and those in their 80s. With the strikes raging all around me this week, I crossed lines and snuck back onto the wards to ask the patients what they have to say. more…

Jane Parry: Organ donation is an emotive topic, and rightly so

28 Apr, 16 | by BMJ

jane_parry3Recently, there was a very moving piece in The Guardian about a doctor’s experience of a family donating their dead child’s organs for transplant. It got me thinking about organ transplantation here in Asia, specifically in Singapore, and why donation rates there are so low.

Singapore has an opt-out organ donation policy: a 2009 amendment to the Human Organ Transplant Act (HOTA) allows for “the kidneys, liver, heart, and corneas to be recovered in the event of death from any cause for the purpose of transplantation, applicable to all Singapore Citizens and Permanent Residents 21 years old and above, who don’t have mental disorders, and who have not opted out.” Opting out of HOTA means that you are lower priority on the waiting list for an organ transplant. more…

Duncan Steele: To strike or not to strike

27 Apr, 16 | by BMJ

duncan_steeleTo strike or not to strike, that is the question we have all asked ourselves over the last few months. To walk away from our patients, albeit to leave them in the care of some of the most qualified doctors in the world, is an incredibly difficult and tormenting decision. The contractual intricacies are complex. The reason why the message from doctors about why this contract is unfair and unsafe has sometimes felt jumbled is because for each of us a particular point of this contract is most important. The list is long: it openly discriminates against women, penalises trainees switching specialty or doing research, extends the week meaning what little social life we have will further be destroyed, pay will be as little as £1.50 to be on call out of hours, we will have shorter breaks and longer days, and there are practical implications for rota design and complex supplements for out of hours work. These are all valid reasons to throw this out. more…

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