Head to head

Should patients be able to pay top-up fees to receive the treatment they want?

Decisions not to fund some treatments under the NHS have been vigorously contested. Yes, says James Gubb, patients should be able to buy such treatments privately. No says Karen Bloor, this will undermine the whole health system.

News

MPs criticise department's handling of Modernising Medical Careers

The Department of Health's handling of the problems with the Modernising Medical Careers programme last year was "inept," and the leadership it showed was "totally inadequate," according to a report published by the House of Commons' Health Select Committee.

Education

Medical management of Crohn's disease

About 690 000 people in Europe have Crohn's disease, including some 90 000 in the United Kingdom. The estimated healthcare costs are €3.04bn. Current treatment options include biological therapy and use of immunomodulators. J R Fraser Cummings and colleagues review therapeutic potential and associated adverse events.

Review of the week

The writing is on the wall for UNAIDS

The exclusive focus on HIV promoted by the Joint United Nations Programme on HIV/AIDS (UNAIDS) is damaging health systems and distorting health financing, and UNAIDS should be closed down immediately, says Roger England, chairman of the Health Systems Network.

Student BMJ

Exams

Should medical students sit a national qualifying exam? Whether it standardises assessment for jobs or leads to yet more pressure and rote learning is debated in the May issue of the Student BMJ. And Daniel Sokol considers the ethical questions that surround examinations. What should you do if someone tells you the answers? "What would a kind, honest, and just medical student do?" he asks.

BMJ Careers

Bearing witness

Toby Elkington describes being summoned to the General Medical Council.

News

US medical schools should say no to drug company support

A report from the Association of American Medical Colleges suggests that all 129 member medical schools should prohibit pharmaceutical and devices manufacturers from providing gifts, food, and travel to doctors, faculty members, and students.

Feature

Everyone's a radiologist now

Are ultrasound machines truly the stethoscope of the 21st century? Should all doctors keep one in their back pocket? Jacqui Wise reports on the battle over ultrasound imaging.

Burma: Cyclone Nargis

It's only human to want to help immediately, but the region will need coordinated assistance rather than well meant but disorganised, unskilled, personal action.

From the archive:
None so naive as the well meaning Penelope Bryant:"It's all very well wanting to help, but it is pointless unless it is done in an organised way - several people [who] explained that most of the infrastructure was washed away by the tsunami and that there was no point sending medical staff who couldn't reach anywhere or be able to treat with even the most basic of drugs. That's why organisations such as Médecins du Monde exist, to avoid haphazard reliance on well meaning individual doctors who jump on aeroplanes to go off on their own to save the world."

Do doctors who volunteer their services in disasters overseas do more harm than good? Hasan Tahir and Zafar Iqbal: "Despite the best intentions of volunteers, it would surely be better for all concerned if they attached themselves to the various well established and regulated bodies that organise the provision of care in such large scale disasters. This would, we hope, eradicate the well intended but unregulated and uncoordinated care provided by medical volunteers."

The tsunami and the dangers of goodwill Andrew C K Lee: "Several of the camps we surveyed received irregular and unpredictable visits by these independent volunteers. Follow-up was non-existent and the distribution of medication haphazard and non-uniform. Antibiotics had been prescribed liberally and it was not uncommon to find internally displaced persons who had received multiple drugs of unknown identity."