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Why the culture of medicine has to change

BMJ 2007; 335 doi: (Published 11 October 2007) Cite this as: BMJ 2007;335:775
  1. Richard Hayward, consultant neurosurgeon
  1. Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH

    Most doctors enjoy buzz of treating individual patients—but they must look at the bigger NHS picture or be sidelined by government, warns Richard Hayward

    Why haven't doctors embraced health service reform? The thought came to me during a recent medicolegal conference with counsel. The year under discussion was 1996, and the issue was a possible delay in referral for a specialist appointment. The general practitioner's letter to the local hospital had been annotated for an appointment “soon” by the consultant (correctly, it was agreed) and “soon” in 1996 meant three months. But before those three months were up the child had collapsed with an intracerebral catastrophe and has been left severely damaged as a result. And my thought was, why did the medical profession remain generally silent for so long about waiting times which for “clinically non-urgent” surgery once stretched to well over a year? It wasn't as if doctors weren't aware of the problem, and I don't buy into the idea that it was all a cynical ploy to boost private practice. …

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