{"id":35380,"date":"2015-10-05T12:42:07","date_gmt":"2015-10-05T11:42:07","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=35380"},"modified":"2015-10-05T12:43:04","modified_gmt":"2015-10-05T11:43:04","slug":"the-bmj-today-when-is-humane-discretion-in-the-nhs-an-offence","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2015\/10\/05\/the-bmj-today-when-is-humane-discretion-in-the-nhs-an-offence\/","title":{"rendered":"The BMJ Today: When is humane discretion in the NHS an offence?"},"content":{"rendered":"<p><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2015\/10\/jeremy_hunt_again.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-35382 \" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2015\/10\/jeremy_hunt_again-150x150.jpg\" alt=\"jeremy_hunt_again\" width=\"139\" height=\"139\" \/><\/a><strong>\u2022 <\/strong>While Jeremy Hunt prepares to tell the Tory party conference about his plans for a seven day NHS, <a href=\"http:\/\/www.bmj.com\/content\/351\/bmj.h5225\">one doctor suggests there are more immediate problems that he should address, namely overcrowding in today\u2019s hospitals<\/a>. David Oliver, consultant in geriatrics and acute general medicine, Berkshire, says: \u201cI have a confession: I sometimes allow patients to stay an extra day or three in hospital, even when they\u2019re technically stable enough to leave. Yes: I know that it\u2019s bad. England has relatively few acute beds. We\u2019ve lost them rapidly, while emergency admissions and delayed transfers have risen inexorably.\u201d<\/p>\n<p><!--more-->He says the problem is overcrowding, and overcrowding hurts: \u201cHospitals become less efficient and safe when bed occupancy is high.\u201d He asks if he was wrong \u201cto exercise some humane discretion\u201d and confesses he is unrepentant.<\/p>\n<p><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2015\/10\/Kadcyla2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-35385 \" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2015\/10\/Kadcyla2-150x150.jpg\" alt=\"Kadcyla2\" width=\"139\" height=\"139\" \/><\/a><strong>\u2022 <\/strong>Elsewhere in <em>The BMJ<\/em>, <a href=\"http:\/\/www.bmj.com\/content\/351\/bmj.h5279\">Zosia Kmietowicz tells of attempts by a pressure group to make the expensive breast cancer drug Kadcyla<\/a> (also known as T-DM1) available to NHS patients. The Coalition for Affordable T-DM1, a group of patients with cancer, doctors, and patient advocates, has called on the health secretary Jeremy Hunt to scrap its patent and allow a generic version to be made. The Cancer Drugs Fund has delisted the drug, which is marketed by Roche and costs \u00a390 000 per patient for a possible extra six months of life. The group says that the \u201cCrown use\u201d provisions of the Patents Act 1977 could be invoked to allow other companies to make a generic version.<\/p>\n<p><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2015\/10\/msf_afghanistan.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-35384 \" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2015\/10\/msf_afghanistan-150x150.jpg\" alt=\"msf_afghanistan\" width=\"139\" height=\"139\" \/><\/a><strong>\u2022 <\/strong>This weekend, Afghanistan witnessed yet another tragedy. US airplanes bombed a hospital in Kunduz, run by the charity M\u00e9decins sans Fronti\u00e8res, killing 12 staff and 10 patients. <a href=\"http:\/\/www.bmj.com\/content\/351\/bmj.h5324\">Adrian O\u2019Dowd recounts the horrors of the event in his news story<\/a>. He quotes from an eye witness account given by one of the MSF nurses, Lajos Zoltan Jecs, who was in the hospital at the time of the attacks. Jecs said: \u201cIt was absolutely terrifying. What we saw was the hospital destroyed, burning. Enough staff had survived, so we could help the wounded with treatable wounds. But there were too many [staff and patients] that we couldn\u2019t help. These [staff] are people who had been working hard for months, non-stop for the past week. They had not gone home, they had not seen their families, they had just been working in the hospital to help people . . . and now they are dead.\u201d<\/p>\n<p><em><strong>Annabel Ferriman<\/strong>, senior news editor, <\/em>The BMJ<em>.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u2022 While Jeremy Hunt prepares to tell the Tory party conference about his plans for a seven day NHS, one doctor suggests there are more immediate problems that he should [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2015\/10\/05\/the-bmj-today-when-is-humane-discretion-in-the-nhs-an-offence\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5750],"tags":[],"class_list":["post-35380","post","type-post","status-publish","format-standard","hentry","category-the-bmj-today"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>The BMJ Today: When is humane discretion in the NHS an offence? 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