Wednesday, 25 March 2015

Chestcracker's Dictum #1 Everyone takes a hit!


Heart surgery used to be a high stakes game for the patient.

It is now a high stakes game for the patient, the commissioner and the surgeon.

Long Live Equity.


Tuesday, 24 March 2015

The Human Cost of Scrutiny?


This story appears in the health section of BBC news online today.
The BBC are wee bit late onto this story. There was an excellent article on the subject of the mental health of NHS staff published 2 weeks ago in the Lancet.
The ever excellent and compassionate Claire Gerada makes some very important points on the need to look after NHS staff.
Maybe noone should be surprised at the findings of these surveys.

Life used to be like this - you are a nurse/doctor. You therefore must be compassionate. You have been trained well. Because of who you are you must be going your best - end of story.

It certainly is not like that anymore.


Monday, 23 March 2015

How to deal with immigration from the EU - make everyone pay - a lesson from the General Medical Council.


In 2008, a locum GP doctor injected David Gray, a patient with typical excruciatingly painful kidney stones, with a fatal (10 times normal) dose of morphine. This act was not intentional but a tragic mistake and it occurred because the doctor who was a German national and whose command of the English language was not good, for want of a better description, screwed up - badly.

Saturday, 17 January 2015

Why Healthcare Insurance to pay for NHS services is probably closer than you think!

Recently, this story featured quite prominently in the UK newsmedia. The response from NHS devotees on social media and blogs was muted. Its significance, in my humble opinion may have escaped obsessees of the UK or English NHS. This is why I think so.
I sit on the cardiac surgery CRG or Clinical reference group.
Please let me explain before you surf away or fall into a deep slumber!!

Monday, 27 October 2014

Mind what you wish for!

Cardiothoracic Surgery in the UK is, as far as the General Medical Council and the Colleges of Surgery are concerned, a single specialty.

Saturday, 25 October 2014

UK Falls Behind in Genomic Medicine Race.

The great Norman Shumway, the true father of heart transplantation, had many witty sayings. One that particularly appealed to me was 'the future of transplantation is xenotransplantation and always will be' reflecting his belief that the interspecies immune hurdles would never be conquered in a clinically meaningful way. The reason this famous Shumwayism appealed to me was the fact that he often visited me in the lab when I was working in the lab at Stanford Universiity in the early 1990s on a xenotransplantation project!

The future of medicine IS genomic medicine - and will become the present long before xenotransplantation ever will. This paper published recently in the JAMA, describes the findings of 2 recent studies and speculates how genomic or more accurately exomic medicine may be used in every day practice in the near future.

Both of these studies come from the U.S. and this should surprise no-one. This contrasts with the protracted and top heavy way genomic medicine is still being organised within the NHS in England as described in this painfully long document published by NHS England - another example if ever we need one of how the UK is falling behind its competitors in the hi tech world of specialist services.