In 1960, Portugal’s infant mortality rate was 77.5 deaths per 1000 live births, which is comparable to that of many Sub Saharan African countries today. In 2010, Portugal’s infant mortality rate was 2.5 deaths per 1000 live births, one of the lowest in Europe and in the world. more…

It took time to think about what happened which is why I am writing about this event a while after it occurred. The shock was hard, and I felt I needed to speak with my friends, in the hope of understanding it.

If you watch what is going in Russia you know that Russia is definitely different to other countries. The number of new billionaires keeps increasing, healthcare and education budgets are scarce, the healthcare system is irrational, expenditure on weapons is going up, there is a culture of xenophobia—specifically anti American and anti UK sentiment, and there is support for regimes like those in Libya, Iran, and Syria. more…

Does it make sense for the state to pay tens of thousands of pounds for a drug that might keep a patient with cancer alive for another six weeks and leave frail elderly people alone and lonely? Is it the right use of resources to keep a 23 week old fetus alive and probably severely disabled for life at a cost of millions when those who care 24 hours a day for doubly incontinent parents cannot afford a break? Very practically, is it sensible for the state to foot the bill for an unnecessary, disorientating, and dangerous admission to hospital for an elderly person with dementia because their social care is inadequate? more…

It takes vision, passion for healthcare, compassion for those who suffer, knowledge, a dedicated team of experts, commitment from all stakeholders, and experience of what it means to be a patient to plan a new strategy for the healthcare sector. These are all missing from what the Greek Ministry of Health has done for the last two years.

What the Ministry of Health has achieved up until now are just separate agreements with different interest groups of the healthcare sector, each fighting fiercely to safeguard their own benefits. Thus, pharmacists have successfully safeguarded their profession, and doctors are allowed to continue practising privately. more…

Spain’s state run healthcare system, one of the best in the world according to the World Health Organization, is facing a serious threat. In the face of growing privatisation, cuts seem inevitable, especially after the overwhelming victory of the conservative Popular Party (PP) in the latest regional elections on 22 May. Since then the PP have issued countless warnings about the insustainability of the healthcare system, to prepare the population for what they are about to do.  more…

Looking at my country’s national health service which is chiefly funded by taxes, from a user’s rather than from a provider’s perspective (or better, from a passive rather than from an active perspective), gives me plenty of food for thought. 

A relative of mine was recently admitted to the local hospital in very serious condition. They had not been feeling well for a couple of days, and I decided to check up on them before leaving for a conference in the north of Portugal, where I was due to chair a session the following morning. more…

Street dwellers, as homeless people are called locally, are ubiquitous in Dhaka. As a health systems researcher, much of my work is far removed from the people around me. Things like systematic reviews, knowledge translation platforms, and capacity building seem to have little immediate impact on the ultrapoor, but recently we completed a small project to help them. 

Four years ago, Dr. Jasim Uddin and I surveyed the homeless in different areas of Dhaka about their health seeking behaviour and living conditions. Although so many of our photos were of smiling families who appeared to be camping under the stars, the abysmal reality uncovered by that study is well documented, and was well received by policy makers, development partners, urban planners, academics, and non-government organisations (Koehlmoos et al. 2009, Uddin et al. 2009).     more…

Sarah Palin may have raised the profile of female politicians, but I’m lifting my glass to the girls who saw me through surgery last week. I did spot the odd male among the panoply of health professionals who looked after me, but they were thin on the ground. From the consultant surgeon and anaesthetist to the kindly soul who sang as she emptied rubbish sacks, mine was a female dominated “hospital episode” and none the worse for it. more…