Saturday, May 22, 2010

UK not interested in 13th century education in Afghanistan

Liam Fox's interview in The Times quotes him as saying "We are not in Afghanistan for the sake of the education policy in a broken 13th-century country". I think he must be meaning that the war isn't about the Taliban banning education for women and making the madrassa the main source of education. I presume he doesn't mean that Islam is not a 21st century religion.

Thursday, May 20, 2010

Richard Gregory obituary

video
Richard Gregory explains the Charlie Chaplin mask in this video.
Read his Times obituary. His book Eye and Brain is known to just about every psychology undergraduate. The use of illusions is important for understanding the dynamic nature of perception. Mind Hacks sums up Gregory's significance well.

Friday, May 14, 2010

Poor measures of quality should not have triggered Mid Staffs inquiry

In a previous post, I said we needed independent academic opinion to publish comment on the use of hospital mortality data to justify the investigation into Mid Staffordshire NHS Foundation Trust (also see another previous post). The recent BMJ editorial by Nick Black is pertinent.

The hospital standardised mortality ratio (HSMR) depends on the proportion of deaths that take place in hospital. Availability of alternative forms of end of life care, such as hospices and community palliative services, as well as characteristics of the local population, therefore, influence the different figures between hospitals. To score well, it's better for a hospital not to admit a dying patient. In fact Mid Staffs has improved its mortality ratio by 34% over the past three years. There are also shortcomings with the HSMR measure itself.

Cavalier use of such data by government and NHS management does not give clinicians confidence that their work is really understood. Unjustifiably singling out a management team that may be no worse than many others is no help. Robert Francis, who conducted an independent inquiry into Mid Staffs, is supposed to be doing a scoping exercise for a further inquiry of the commissioning, supervisory and regulatory bodies, which has draft terms of reference.

Wednesday, May 12, 2010

Need for inquiry after David Southall wins appeal

PACA press release. Why is it that the GMC gets these sort of matters wrong? Doctors need to have trust in the GMC that it will not make defensive risk averse decisions. I have always supported David Southall (see previous post and letter to THES).

David Clark obituary

Guardian obituary of David Clark. His book Social therapy in psychiatry influenced me. I also trained at Fulbourn Hospital, although Clark had just retired before I started as a junior psychiatrist there. His history of Fulbourn Hospital (The story of a mental hospital) is of interest.

It's important the history of the therapeutic movement in psychiatry is not forgotten. A major advance in psychiatric care was the opening of the doors of the traditional asylum. Unfortunately, to some extent, there has been a reinstitutionalisation of psychiatric care and sometimes the worst excesses of the asylum are now repeated in the community. Risk averse policies and interventions can actually cause problems for patients in terms of their rehabilitation and recovery.