Medicine and Science from The BMJ

The NHS market place

The new coalition government’s plans for the NHS in England put GPs firmly in the driving seat - how do their secondary care colleagues feel about that?Jacky Davis, co-chair of the NHS Consultants’ Association and a founder member of the “Keep our NHS Public” campaign, shares her views with Duncan Jarvies. Duncan also talks to Professor Julian Le Grand from the London School of Economics about how market pressures can help make health care more efficient and what GP fundholding taught us.To see all BMJ Group’s articles about the NHS white paper for England, including discussion threads, podcasts, blogs, and learning modules, visit doc2doc.bmj.com/whitepaper

Musical lithotomy

In June 2010 the drug company Novo Nordisk announced that its only conventional human biphasic insulin, human Mixtard 30, would no longer be available in the UK from January 2011, a decision that affects an estimated 90,000 patients Drug and Theraputics Bulletin (DTB), one of the BMJ’s sister journals, is campaigning against that decision. DTB editor Ike Ihenacho talks about the campaign.Mabel Chew talks to the authors of a rational testing article on what to do about mildly abnormal serum amine transferase levels, what to suspect, and how to diagnose.Finally, we have a musical interlude.

Heavy weather

In this week’s podcast we discover the link between the weather and the risk of heart attacks - Krishnan Bhaskaran tells us about his research.Also, criticism and response are crucial parts of the scientific process, but how well do authors of research papers respond to critics of their work? Peter Gøtzsche and Tony Delamothe discuss their work looking at that in the BMJ.

The hidden eunuch

Jill Morrison talks about how people on long term incapacity benefit because of mental health problems could be identified by their GPs three years before they stop working.BMJ Deputy editor Trish Groves explains more about the journal’s new policy of asking authors of eligible research articles to pay a publication fee.And, finally, why does the modern eunuch remain invisible?

Shit happens

This week, to steal a line from the latest BMJ editor’s choice, we’ll be talking shit. The millennium development goal on sanitation is way off track; Lyla Mehta, a sociologist from the Institute of Development Studies, tells us why, and Kamal Kar, a development consultant from India, explains how his grass roots initiative changes the way people view sanitation.Also, National confidential enquiry into patient outcome and death reported on cosmetic surgery this week. Dr Alex Goodwin, anaesthetist and clinical coordinator of the report, tells us about the problems they had collecting data, and some of the implications of their findings.

NICE in America

In this week’s podcast we find out from Sean Tunis about the future of comparative effectiveness research in the USA, and how the new institute created to champion it will differ from the UK’s National Institute of Clinical Excellence.Also, Claudia Cooper talks about her research that could support carers in the decisions they have to make for dementia sufferers.

Rational suicide

A person’s right to refuse treatment is based on their capacity to make a rational decision – but what is the situation when someone is admitted after a suicide attempt? Can you be simultaneously rational and suicidal? Anthony David from the Institute of Psychiatry gives us his views.A second interview deals with Barrett’s oesophagus, which is on the increase. The same is true for adenocarcinoma of the oesophagus, which can arise from the condition. We talked to Rebecca Fitzgerald from the Hutchison/MRC Research Centre how developments in treatment, and a new method of sampling, could make a national screening test a possibility.

Spotlight on palliative care beyond cancer

In a series of articles, this spotlight focuses on recognising and managing the end of life, having the difficult conversations with patients about their death, and the importance of taking into account the spiritual aspects of death. In this podcast Duncan Jarvies talks to the authors of 2 of those articles.Professor Jane Maher, oncologist and CMO of Macmillan Cancer Support, talks about the importance of end of life care. Dr Mike Knapton, GP and CMO of the British Heart Foundation, talks about their move into palliation.

Radical reforms

This week we’re joined by Martin McKee, professor of European public health at the Loncon School of Hygiene and Tropical Medicine. He’s also research director of the European observatory on health systems and policies, a group that promotes evidence based healthcare policies in Europe.We’ll be discussing the effect the squeeze in funding is having on health care in Europe, and the various strategies different countries are using to save money.

Safety comes second

Last week saw Safety 2010, the international conference on preventable accidents. We hear from some of the speakers there why safety comes second when it comes to global health.Also this week, female sexual dysfunction - fact or fiction. In advance of a BMJ debate on the topic, we get to the heart of the issue.