Personal Views

The government's initiative may be stillborn

BMJ 1998; 317 doi: (Published 05 September 1998) Cite this as: BMJ 1998;317:687
  1. Malcolm Frazer
  1. consultant obstetrician and gynaecologist, Warrington

    In one of the numerous documents I have received on the NHS white paper for England I read the following: “Clinical governance encompasses all the processes needed to achieve the highest quality clinical practice possible within available resources.”

    The last subordinate clause of that sentence is a killer and holds within it the reason this initiative may well be stillborn. In order to achieve the “highest quality of clinical practice” I need certain things.

    I need good quality information. l want this from a source I trust and respect. It should be easy to assimilate and have realistic goals. It also needs to address a commonly encountered clinical scenario. Local sources are best, preferably from someone occupying a similar post in a similar hospital to my own. I will look with the utmost cynicism on poorly written reports or recommendations handed down from ivory towers concerning diseases I hardly knew existed. Does anyone know whether this good quality information exists? In obstetrics and gynaecology it is quite hard to find data of sufficiently high quality to help …

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