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Juliet Dobson: Cutting support services for new mothers is a false economy

1 Jul, 15 | by BMJ

juliet_dobsonI was sad to hear that support services for new mothers are going to be cut across England. The Guardian reports that breastfeeding classes, home visits from midwives, and “babyfeeding cafes”—where mothers can drop in and talk to feeding advisers as well as other parents—are increasingly being scaled back or cut owing to pressures on local authority and NHS budgets.  more…

Martin Marshall: The travesty of the 10 minute consultation

29 Jun, 15 | by BMJ

martin_marshall“Perfunctory work by perfunctory men.” That’s how an eminent physician once described general practice. “A ridiculous claim” cried GPs, rising to the defence of their discipline, “specialists just don’t understand the nature of general practice. They don’t value our ability to make quick decisions based on a deep understanding of our patients and their context, our exceptional skill at managing risk and uncertainty, of using serial consultations to optimise the effectiveness of our diagnostic and therapeutic interventions.” more…

David Eedy: What lessons can be learned from the collapse of dermatology services in Nottingham?

23 Jun, 15 | by BMJ

david_eedy_picThe independent investigation into the near collapse of the acute and paediatric dermatology service in Nottingham has called the process an “unmitigated disaster.” This collapse was foreseeable and avoidable, and in the aftermath of the report it is important that clinical commissioning groups (CCGs), trusts, and private providers nationally take on-board what went wrong to prevent similar mistakes being made in the future.

The report found that no one organisation was to blame for the collapse of the service, which is not quite the same as saying the organisations are blameless. more…

Marge Berer: Jeremy Hunt supports 12 week limit for abortion

8 Oct, 12 | by BMJ

At the Labour conference last week, Andy Burnham accused Jeremy Hunt of failing to make any statements about important current health service issues in parliament since he became health secretary. What a pity he decided to speak up last week, because now we know just how uninformed he is. Hunt said he favoured reducing the abortion time limit to 12 weeks. Really? How much more irrelevant can it get with this government? But he wasn’t alone. Maria Miller, who became women’s minister in the recent shuffle, had already expressed her personal opinion on the abortion time limit in the Guardian. Theresa May was then pushed to take a view on the Today programme on Saturday, and (not to be left out) David Cameron also offered his two cents’ worth on the BBC. A bit like lemmings, except that they all had different views, and the government, according to Cameron, has no plans to put forward legislation anyway. Still, every news outlet in the country seems to have picked up on it. Is that what the media are for these days—to report every off-the-cuff, unthought-out opinion that comes down the road? Give me a break. This is non-news. more…

Peter Bailey: Own up and ask for help

10 Sep, 12 | by BMJ

When I was twelve, I had a splendid bicycle. I cleaned and oiled and polished it. I looked for ways to improve it. One day, I thought I would take the Sturmey Archer three speed gear hub apart to oil it and make it work better, faster, and more smoothly for less effort.

I knew it would be a complex job, so I studied diagrams first and read bike maintenance manuals. When I was sure I knew what I was doing, I made a start. I carefully laid the parts out in a line as I dismantled the hub. My father looked over my shoulder and said “Are you sure you know what you’re doing?” and my Mother said “You’ll need to clear those parts off the table in time for supper.” more…

NHS pension strike—we are preparing to make a stand

15 Jun, 12 | by BMJ

We are planning to take industrial action at our GP surgery. We’re unanimous about the blatant inequity being thrust down our throats by Mr Lansley and the anger we feel is palpable. We weren’t completely in agreement about what we’d be prepared to do about it—but when the date was announced, we realised that the two doctors who were less sure about what they wanted to do would be absent anyway on 21st June—and as long as we kept our patients safe, they didn’t stand in the way of the rest of the team taking action. In fact deep down they know it’s the right thing to do. On the day it has to be all for one and one for all—and so it will be. more…

Martin McShane: Win, win, win?

23 May, 12 | by BMJ

Martin McShaneIn the last week, I have managed to catch up with two old friends who are the sort of GPs who I would be delighted to look after me or my family. As I listened to them both, I empathised with the pressures general practitioners face. On top of the burden of more and more patients with co-morbidities for whom more and more is expected from general practice, GPs are expected to find time to get deeply involved in commissioning. The pressures on GPs and practices are growing and they are under strain. more…

Richard Smith: Are we too concerned with confidentiality? A fable

4 May, 12 | by BMJ

Richard SmithI am the chief medical officer of our family. I am the bridge between my family members, some of them eccentric and one of them demented, and an unforgiving health system. Many doctors—indeed, anybody familiar with the strange language and rigidities of health systems—fulfil the same role, and it gives us some useful bottom up views of our health service.

Most of my endeavours are on behalf of my mother, a marvellous woman who is strong on joy and humour, but who has no short term memory. Together we are on track to write an NHS equivalent of Rumpole of the Bailey (in case you don’t know, hilarious stories of legal absurdities). more…

Martin McShane: 80:20

19 Apr, 12 | by BMJ Group

Martin McShaneWe are working through trying to understand exactly how commissioning support (CSS) will work with Clinical Commissioning Groups (CCGs). At a recent time out the lead manager for the CSS presented on the progress being made with Greater East Midlands CSS (GEM). They highlighted the scale of work that is required with the 277 tasks in the development plan. One of the Chief Operating Officers presented the programme of work required to see through the transition from a CCG. As they pointed out, this was a transition plan—for which the work required for authorisation is a component, not the be all and end all. There is as much to do to develop the CCGs as there is to develop the CSS—and they are mutually dependent. more…

Mike Knapton and Tom Pierce: Doctors should take a leading role in tackling climate change

11 Apr, 12 | by BMJ

The recent Cambridge University Leadership Programme looked at sustainable development in health services worldwide. It was an opportunity to hear the evidence and arguments which were both persuasive and alarming. The link between population growth and our reliance on a carbon-based economy, leading to rising levels of CO2 in the atmosphere, and the consequent changes in climate was compelling. This is relevant to healthcare systems, and the professionals that work within it, not only because climate change itself is having significant consequences on the health of populations, but because healthcare systems themselves have a significant carbon footprint. more…

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