I love the NHS

Oh yes I do, and if you're British, I hope you do too!

Yesterday, the Supreme Court in America voted to uphold the Affordable Care Act.  It may not be a national health service as we know it, but in passing it, the USA goes one step closer to making sure everyone will be able to access medical care.  
Now, if any Americans read this blog, it remains a mystery to most people I have spoken to in the UK as to why one would oppose this law.  44 million Americans don't have health insurance.  38 million additional people have inadequate health insurance.  That equates to around one third of American citizens potentially being unable to access healthcare.  The USA is probably the richest country in the world, but the life expectancy is 50th in the world.  And yet 31% of Americans believe they will be harmed by the Affordable Care Act?

National Health Care does not equate to communism.  It doesn't mean you can't still pay for a private provider if you have the money. It means you're saying that it matters to you that everybody can go to the doctor if they need to.  Of particular concern to me is the effect on people with chronic diseases - and with the ageing population, it is vital that healthcare systems are in place to support people through lengthier, more complex disease trajectories.

I read on CBS that the fundamental opposition is that people want a better economy more than they want a better health care system.  This is the ultimate mystery to me - better healthcare, healthier workforce, healthier economy (as evidenced by a 2006 study by McKee and colleagues).  But surely this is a question of social responsibility, believing that your neighbour deserves the same care as you'd hope to get, regardless of the size of his pay cheque.

At BMA conference

I'm not trying to put together a thorough and detailed argument, but at the end of the day, the NHS is an amazing organisation and one that we must defend.  It's not perfect, of course (that's for another time).  But the point is, as a doctor, I know I'll be able to care for anyone who needs care, and as a person, I know that my friends, family and indeed anyone can be assured of treatment regardless of their healthcare ailment.  We have our own battle in the UK with the Health and Social Care Act - and that's to prevent us going to the very system that Obama's trying to change.  

Open Access - advantageous for all

Sea.... sun.... sand.... well, it's out there, but I'm spending rather more time indoors at the BMA's Annual Representative Meeting in Bournemouth.  One full day down has seen debates regarding key issues affecting medical students and junior doctors, the health reforms, health inequalities... to name but a few.

I'm delighted to report that the BMA voted to support Open Access, and to support the work of the Right to Research Coalition!  Great that the medical profession, from medical students up to senior doctors and GPs support Open Access.


I read this paper today which evaluates how successful openly published papers are - very, apparently.  It offers a brief meta-analysis of papers that explore Open Access citation advantage.  It suggests that the majority of papers published with free availability are more heavily cited - a 300-450% advantage for medical papers.  It makes complete sense - the more people who can read your work, the more likely it is to be cited - but it's heartening to see it in figures and numbers.  Having intercalated and spent a few months in a lab with full-time scientists, it is clear that having your work published and cited is absolutely fundamental to the ongoing success of research groups and therefore scientific progress.  Further evidence that we must promote Open Access to help spread the word and drive research forward.

As Professor Averil Mansfield, Chairman of the Board of Science at the BMA, reminded us today, doctors have a powerful role to play in promoting issues we believe are important, raising their profile to both the government and the public.  She spoke about what has been done to tackle smoking, obesity, road safety, illicit drug use - it just shows that we must use our voice across a broad range of issues, and Open Access must be no different.