I have met clinicians and patients in many parts of England in the last five years and here is a list of the type of questions that cannot be answered.

1.    Is the service for people with seizures and epilepsy in Manchester better than the service in Liverpool?

2.    Who is responsible for the headache service for people in Warrington?

3.    How many liver disease services are there in England and how many should there be?

4.    Which service for frail elderly people in London provides the best value? more…

What follows is an email debate between Melanie Lovell, a palliative care physician in Sydney, and Richard Smith, former editor of the BMJ and chair of Patients Know Best. The debate began when Richard asked if Melanie had seen the editorial that he had written with two colleagues arguing that we need to take a more positive attitude to death.

ML: The deaths of patients who accept their situation and make the choice to use the period prior to death to heal relationships, cement their legacy, and prepare themselves for death and their families for a future without them, can be beautiful, peaceful and even joyful times of celebration and thanksgiving. Of course they are sad times too. This contrasts sharply with deaths of those who deny death and can die without the preparation which is so helpful. more…

David Cameron and Andrew Lansley assert that a large majority of GPs support their bill. Is it true? Where is the evidence? Is the profession lined up in willing support, eager to take on responsibility for managing the NHS through its greatest crisis? Perhaps we all took the King’s Shilling while in our cups in the taverns and only now are waking up to find ourselves press-ganged aboard a merchantman across uncharted seas in the government’s service. more…

Hippocrates (c.460 BC–370 BC) is often described as “the father of modern medicine.” Wise and knowledgeable though he was, he was, in truth, a late-comer.

The medicine of the ancient Egyptians dates from the beginnings of the civilization in about the 3rd century BC to the Persian invasion of 525 BC and was remarkably sophisticated for its time. Ancient Egyptian doctors undertook simple surgery, were able to set bones, gave careful attention to safety in childbirth, and developed a comprehensive pharmacopoeia, based largely on herbal and other natural treatments—in truth, some of them inherently dangerous. They also understood the importance of personal hygiene and diet. They enjoyed an excellent international reputation, and rulers of other empires would ask Egyptian pharaohs to send them their best physicians to treat themselves, family members, or favoured friends. more…