Young doctors are bright, often highly creative, highly energised people. It is hardly surprising that some of them have very highly developed entrepreneurial skills. What is more surprising is that the establishment does not harness young bright brains and use them to their full potential as any other industry would do.

The NHS tends to somewhat distain new ideas from anywhere other than the traditional academic world of scientific breakthrough, double blind trails and learned papers. Instead of encouraging innovative thinking in junior doctors, the tradition has been - apart from in a small number of forward-thinking organisations - to ignore it.

What if a pair of fresh bright eyes, close to patients and the clinical frontline happens to spot a new way of doing things that improves the process; the way patients feel; or maybe a radical way of communicating key information to clinicians who work at strange times of the day and night?

What if those fresh eyes see ways through problems that others, with their eyes tired from being so close and their minds, brainwashed and stuck in a groove of ‘this is how it is and always will be’ have tried for years to solve?

Huge, complex, publically-funded organisations like the NHS are not on the whole given to welcoming entrepreneurial thinking. Indeed, an indicator of how well the would-be entrepreneur is doing can be measured in terms of the number of times per day they are told to ‘not rock the boat, doctor’.

Yet, the complexity of running healthcare, free for all at the point of delivery is unlikely to become miraculously easy over the next few years of financial constraint. And it may just be that the NHS can no longer afford to ignore the innovative ideas of its junior doctors.

Jenny wrote the lead editorial for our summer issue on 'Medrepreneurs'. Read the full issue here.

 

 

The latest government proposal to prevent people smoking is to sell cigarettes in plain packaging. Now I’m happy for the government to do whatever they feel is necessary, but how is plain packaging going to help?



Maybe I am overestimating society but I really don’t believe people pull out their cigarette packet to the gasps of those around them and the admiration which comes with smoking such a “cool” brand of cigarettes.

Maybe I am mistaken: perhaps packaging is for cigarettes what the ipod is for mp3 players, but I doubt it.

Smoking is an atrocious habit. Whenever I sit a medical exam and I’m asked for an aetiological factor for a disease I can guarantee I’ll get a mark if I put smoking… gastric ulcers, hypertension, colon cancer… smoking causes literally everything.

The smoking ban is probably one of the best initiatives the current government has implemented. But they are clearly scraping the barrel for ideas with this one.

Not that the tobacco companies are completely logical, instead of drawing the evidence together that changing the packaging is going to have little effect on the prevalence of smokers. Gareth Davis, chief executive of Imperial Tobacco claimed a lack of packaging would allow the illicit counterfeiting cigarette trade to grow.

I’m sorry but my initial reaction is so what? Counterfeiting is usually dangerous as products can be cut with dangerous chemicals. Anybody who places a legitimate brand of cigarette in their mouth is already exposing themselves to a significant risk to their health.

Image: Maggie Smith / FreeDigitalPhotos.net

Finally the biggest controversy in medicine of the last two decades is coming to an end.



Andrew Wakefield was found to have acted unethically, dishonestly and irresponsibly by the General Medical Council (GMC) in his controversial research which linked the MMR vaccine to autism.

From April the GMC will decide if he showed serious professional misconduct and what sanctions should be imposed, which could include being struck off.

The hearing that lasted for two and a half years didn’t attempt to prove or disprove a link between autism and MMR but to detail if he acted ethically in his methods of research.

So just what did they find…

He had communicated with a solicitor who was representing those who had allegedly suffered harm due to the MMR vaccine. Not only that, but Wakefield had his research funded by the Legal Aid Board which the solicitor had applied for.

He was also involved with a patent for a safer vaccine which could replace MMR.

Furthermore he failed to mention the disclosable interests of the legal aid and patent to the Lancet, the paper which originally published the paper.

Wakefield admitted to being aware that the paper he wrote would form a link between autism and MMR and that this would have public health implications.

He was dishonest in the paper by stating that the children in the study had come from a normal referral pathway i.e. referred from a GP to the paediatric gastroenterology department. However four of the children were referred for investigated into the role of MMR in the development of their autism. And another four were actively referred by Wakefield. Together this produced a biased selection of patients.

Andrew Wakefield was also found to have taken blood from children at his sons birthday party and paid each child £5. He then joked about this incident and said he would do it again. This represented a callous disregard for the distress and pain the children suffered and abused his position of trust.

When Wakefield linked autism to MMR the rate of vaccination fell and children started to suffer from the three deadly infectious diseases. He has since moved to Austin, Texas, where he doesn’t practice medicine but does receive a high salary for his involvement with a centre for autism.

The rates of vaccination have never recovered.

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A British man who suffers from a mental illness has been sentenced to death in China and may be put to death as soon as Tuesday.



Akmal Shaikh travelled to China following the delusion that he could become a pop star. The charity, Reprieve are claiming that his mental illness left him susceptible to people who tricked him into carrying heroin.

His family have travelled to China to insist a full mental health evaluation should be performed. But why hasn’t he undergone a psychiatric examination already?

How can a person with a past history of bipolar disorder and delusions be treated as a healthy individual who has maliciously committed a crime?

And just why can’t Britain look after its own?

According to reports Gordon Brown and David Miliband have attempted to prevent the execution. But it seems that China is still going to go ahead and kill a delusional man.

The case runs in parallel with that of Asperger's sufferer Gary McKinnon. Gary hacked into US military computers whilst looking for evidence of UFO’s. America applied to have him extradited for trial. The high court failed to prevent his extradition. And now his only hope lies with the European Court of Justice.

If the Brit is sent to America he could face 60 years in prison. More worryingly Gary has suicide tendencies and the stress he is under could lead to him attempting to end his own life.

So just why does Britain lack the ability to protect it’s vulnerable citizens? Does the rest of the world have so little respect for the UK that countries can do as they wish with our mentally ill?

You have to question just what the rest of the world currently thinks of the UK.

Bill Clinton made an unexpected trip to North Korea earlier this year. He travelled back to the States with two American journalists who had been imprisoned for entering the country illegally.

And Gordon Brown can’t even prevent a mentally ill British national from being put to death.

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This week the sexual assault and harassment case against gynaecologist, Angus Thomson was dropped. Bibi Giles had accused him of sexually assaulting her during an intimate examination.



This was despite a nurse chaperone presence. As the defense had not yet sat the nurse didn’t have the chance to testify.

It was clear to anybody who followed the case that the whole fiasco was absolutely ridiculous. How could the case have even got to court when there was a chaperone present?

The accusations became even more unbelievable when it was revealed Bibi had attempted to start a relationship with the consultant and had even sent the doctor a sexually explicit and inappropriate text message.

Married Bibi Giles dropped her case after her former GP stepped forward claiming she had made similar advances towards him.

I am so disgusted that the case went to court. I’ve experienced the effect these kind of court cases have on doctors.

Being female I’ve been asked to chaperone male doctors on numerous occasions. If there isn’t a female chaperone present a male doctor cannot take the risk of examining a woman regardless of the seriousness of the patient’s potential condition.

For three years Mr Thomson has been subjected to the ordeal from Mrs Giles.

Bibi was described as a “fantasist” after it was revealed she claimed to have once been Miss Guyana, had treated Michael Jackson and Oprah Winfrey. She even insisted her husband was a Russian diplomat (he was a quantity surveyor).

What has happened to the sacred doctor-patient relationship? How can a woman make advances to a married doctor and when they aren’t reciprocated accuse him of sexually assaulting her in a medical consultation? And more importantly how could this case have gone so far?

I honestly hope Mr Thomson can return to his job as he did before. But it is likely the effect of this case will remain with him and he could be scared this kind of incident could happen again. It’s a sad day when someone who dedicates their life to helping people cannot do their job for fear of people like Bibi.

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A report has been published from the Alzheimer’s Society, pointing out a number of flaws in the hospital care of those with dementia.

It comes just a week after the news broke that patients with dementia are being prescribed antipsychotics inappropriately and the subsequent side effects lead to 1,800 deaths a year.

Dementia, is the global impairment of mental functioning, this occurs in a clear consciousness and is usually progressive.

The condition is usually caused by cerebrovascular disease (a problem with the blood vessels in the brain e.g. a stroke) or Alzheimer’s, the cause of Alzheimer’s is unknown but it is likely to be due to genetic factors.

Dementia affects a person’s memory and causes them to become disorientated, the person’s awareness is lost and the disease also changes a person’s personality and behaviour.

The combination of symptoms places pressure on the staff responsible for the care of dementia patients.

The report form the Alzheimer’s Society outlines failures in the care of dementia patients and was determined by questionnaires from over 2,000 carers and nurses.

It stated that people with dementia occupy 1 in 4 hospital beds and they stay longer in hospital than patients without dementia. Not only does this cost the NHS but it has a negative effect on the patients symptoms and physical health.

More than 1 in 3 dementia patients are discharged to a care home despite living at home prior to admission.

1 in 4 nurse managers and nursing staff felt antipsychotic drugs were inappropriately prescribed.

Carer’s determined the main problems were, a lack of:

• Understanding of dementia by staff
• Individual care
• Help with eating and drinking
• Social interaction
• Involvement in decision making
• Dignity and respect

Nursing staff felt the main concerns were:

• Managing difficult behaviour
• Communicating
• A lack of time to spend with patients

The report suggests that the number of people with dementia being cared for in hospitals should be reduced. This means funding should shift into community care.

It also suggests carers, friends and family should be involved in the care and decision making process. And a individual care plan should exist for each patient, which focuses on the patients likes and dislikes.

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