Intended for healthcare professionals

Feature The Medical Year

2010: a nudge in the wrong direction

BMJ 2010; 341 doi: (Published 21 December 2010) Cite this as: BMJ 2010;341:c7248
  1. Jeremy Laurance, health editor
  1. 1Independent, London W8 5HF, UK
  1. J.Laurance{at}

With scandals in the headlines and a new government making its mark, 2010 will not go down as a good year for medicine, says Jeremy Laurance

The NHS started 2010 in the peak of condition. Funding was at an all time high, waiting times at an all time low. Heart disease and cancer deaths were heading down, hospitals and health centres going up. The medical workforce was the largest ever, and public satisfaction was at record levels. The health service had never had it so good.

But by the year’s end, it was looking pale and feverish. Funding was frozen, savings being demanded, and cuts being made. Days after the election in May, the coalition government promised no more top-down reorganisations of the NHS—before launching the biggest reform in its history. And no one seemed to know why.

Elsewhere, there were comings and goings. MMR vaccine refusenik Andrew Wakefield, “legal high” mephedrone, NICE’s rationing role, diabetes drug rosiglitazone (Avandia), and two experts from the WHO’s pandemic response committee went (or were on their way out). The Mid Staffordshire inquiry, the cancer drugs fund, food firms’ role in public health, and the importance of brushing your teeth came (or were coming). It was the year of nudge.

25 February: Hospital scandal

In one of the darkest days in NHS history the report of the inquiry into the Mid Staffordshire NHS Foundation Trust painted a picture of healthcare in Britain that belonged to another age. Patients were left lying in soiled sheets, crying out in pain, frightened and ashamed, and so thirsty they were forced to drink water from flower vases. Care was so lacking in the basic essentials that lives were sacrificed as a result, Robert Francis QC, the chairman said. A focus on financial targets rather than patient welfare was blamed for the culture …

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