Skip to main content

Main menu

  • HOME
  • ONLINE FIRST
  • CURRENT ISSUE
  • ALL ISSUES
  • AUTHORS & REVIEWERS
  • SUBSCRIBE
  • BJGP LIFE
  • MORE
    • About BJGP
    • Conference
    • Advertising
    • eLetters
    • Alerts
    • Video
    • Audio
    • Librarian information
    • Resilience
    • COVID-19 Clinical Solutions
  • RCGP
    • BJGP for RCGP members
    • BJGP Open
    • RCGP eLearning
    • InnovAIT Journal
    • Jobs and careers

User menu

  • Subscriptions
  • Alerts
  • Log in

Search

  • Advanced search
British Journal of General Practice
Intended for Healthcare Professionals
  • RCGP
    • BJGP for RCGP members
    • BJGP Open
    • RCGP eLearning
    • InnovAIT Journal
    • Jobs and careers
  • Subscriptions
  • Alerts
  • Log in
  • Follow bjgp on Twitter
  • Visit bjgp on Facebook
  • Blog
  • Listen to BJGP podcast
  • Subscribe BJGP on YouTube
Intended for Healthcare Professionals
British Journal of General Practice

Advanced Search

  • HOME
  • ONLINE FIRST
  • CURRENT ISSUE
  • ALL ISSUES
  • AUTHORS & REVIEWERS
  • SUBSCRIBE
  • BJGP LIFE
  • MORE
    • About BJGP
    • Conference
    • Advertising
    • eLetters
    • Alerts
    • Video
    • Audio
    • Librarian information
    • Resilience
    • COVID-19 Clinical Solutions
June Focus

June Focus

David Jewell
British Journal of General Practice 2004; 54 (503): 409.
David Jewell
Roles: Editor
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info
  • eLetters
  • PDF
Loading

‘Book burning and the imprisonment of editors will not join the repertoire just yet’, writes Theophrastus on page 475. That's a relief, particularly as this issue of the BJGP finds itself straying into mildly controversial territory. Many readers will remember the BMJ paper published in 2002 claiming that the Kaiser Permanente Health Maintenance Organisation in the United States was much better value for money than the National Health Service. The paper on page 415 echoes the vigorous correspondence that followed the original BMJ paper, pointing out dubious assumptions and concluding that the claims simply don't stand up to critical scrutiny, and that to base UK policy on them is misguided. Not so, reply the authors of the original article on page 422. They stand by their conclusions and quote two later studies in support. However, in the editorial on page 410, Trevor Sheldon sides with the critics. He too feels that the original comparison was flawed, but also implies that the very attempt to make such international comparisons is always going to be difficult. The UK's Department of Health is charged with looking for easy solutions from abroad, rather than trying to draw on good innovative practice at home. The words of HL Mencken come to mind: ‘To every complex problem there is a solution that is simple, straightforward, … and wrong.’ On page 482, from across the Channel comes a distant echo in support of Trevor Sheldon's argument. For many years, critics of the UK's NHS have pointed to the wonderful French system to show us all what we should be doing. However, all is not well in France, with doctors disillusioned and planning early retirement. Heard that somewhere before? Or, as the Guardian put it after the last French elections: ‘The French healthcare system may be the best in the world, but the French cannot afford it.’ Paul Hodgkin on page 479 argues that there is something fundamentally wrong with our current methods of examining healthcare systems. For better understanding we should see them as gift economies, and stop trying use market models. His illustrations will be eerily familiar to many UK general practitioners.

Numerous papers over the years have raised worrying doubts about the equity of access for patients with heart disease, specifically whether women and ethnic minorities are being discriminated against when it comes to angiography and coronary artery bypass surgery. The study from the East End of London on page 423 comes to encouraging conclusions, with neither ethnicity nor deprivation appearing to influence access to angiography services. The study on page 442, using data from surveys across the whole of England, also showed that there was no influence from ethnicity in the prescription of lipid-lowering drugs. However there may be some influence both from deprivation and from age. The commentary on page 427 is a reminder of the problems of ecological studies, while Julia Hippisley-Cox's leader on page 411 points out that potential ageism in this particular field could be made worse by the existing public policies.

As in the May BJGP, considerations of access surface again in Mike Fitzpatrick's column on page 485. In this commendably Luddite scepticism towards technologically driven solutions for old problems (Mencken again) he is joined by Hay and colleagues on page 448, inviting us to be as wary of infrared thermometers as the BJGP previously warned we should be of electronic sphygmomanometers and weighing machines. James Willis weighs in on page 488 with concerns about confidentiality and electronic records — this one will run and run. Amid such outbursts it is good to be reminded that ‘Music has charms to sooth a savage breast’ (Theophrastus again). There is the photograph of the President of the RCGP and friends playing in Bournemouth (page 476), and the prospect of the European Doctors' Orchestra in Blackheath later this year (page 475). Like Theophrastus, I can only imagine how awful to be tone deaf, or, thinking of Beethoven at a concert of two of his late string quartets, completely deaf.

  • © British Journal of General Practice, 2004.
Back to top
Previous ArticleNext Article

In this issue

British Journal of General Practice: 54 (503)
British Journal of General Practice
Vol. 54, Issue 503
June 2004
  • Table of Contents
  • Index by author
Download PDF
Article Alerts
Or,
sign in or create an account with your email address
Email Article

Thank you for recommending British Journal of General Practice.

NOTE: We only request your email address so that the person to whom you are recommending the page knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
June Focus
(Your Name) has forwarded a page to you from British Journal of General Practice
(Your Name) thought you would like to see this page from British Journal of General Practice.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
June Focus
David Jewell
British Journal of General Practice 2004; 54 (503): 409.

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

Share
June Focus
David Jewell
British Journal of General Practice 2004; 54 (503): 409.
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
  • Mendeley logo Mendeley

Jump to section

  • Top
  • Article
  • Info
  • eLetters
  • PDF

More in this TOC Section

  • Chronic Disease and Comorbidity
  • June Focus
  • June Focus
Show more June Focus

Related Articles

Cited By...

Intended for Healthcare Professionals

BJGP Life

BJGP Open

 

@BJGPjournal's Likes on Twitter

 
 

British Journal of General Practice

NAVIGATE

  • Home
  • Current Issue
  • All Issues
  • Online First
  • Authors & reviewers

RCGP

  • BJGP for RCGP members
  • BJGP Open
  • RCGP eLearning
  • InnovAiT Journal
  • Jobs and careers

MY ACCOUNT

  • RCGP members' login
  • Subscriber login
  • Activate subscription
  • Terms and conditions

NEWS AND UPDATES

  • About BJGP
  • Alerts
  • RSS feeds
  • Facebook
  • Twitter

AUTHORS & REVIEWERS

  • Submit an article
  • Writing for BJGP: research
  • Writing for BJGP: other sections
  • BJGP editorial process & policies
  • BJGP ethical guidelines
  • Peer review for BJGP

CUSTOMER SERVICES

  • Advertising
  • Contact subscription agent
  • Copyright
  • Librarian information

CONTRIBUTE

  • BJGP Life
  • eLetters
  • Feedback

CONTACT US

BJGP Journal Office
RCGP
30 Euston Square
London NW1 2FB
Tel: +44 (0)20 3188 7400
Email: journal@rcgp.org.uk

British Journal of General Practice is an editorially-independent publication of the Royal College of General Practitioners
© 2022 British Journal of General Practice

Print ISSN: 0960-1643
Online ISSN: 1478-5242