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…

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…

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…

In 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…

I 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…

We 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…

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…

It is all over now. The Health and Social Care Bill has been passed. The politicians have moved on, content to leave professionals and managers to pick up the pieces. Whichever side of this exhausting, divisive, and passionate argument you favoured, we are in a different place now. It is no longer a question of should we or shouldn’t we? Instead it is: how do we make this radically different NHS work for our patients? And how do we avoid reasonable fears about the bill from becoming a reality? 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…

So why would a retired professor of public health decide to write a protest song, get his kids to help him record it, his wife to help him with the graphics, and take his first plunge into the dangerous world of YouTube? Isn’t this the fellow that usually writes dusty academic works about evidence-based practice? The answer is that the song was indeed an attempt at evidence-based practice, just one more tool in the struggle to prevent a major threat to the people’s health, namely Andrew Lansley’s Health and Social Care Bill. more…