I am Jonathon Tomlinson. I am an NHS GP working in Hackney, London. I originally set up this blog to inform twitterers and others about the great scandal going on with the NHS, which is its conversion into a pre-1948 (start of the NHS) market economy as a result of steady lobbying from UK and US private health insurers and a prevailing neoliberal political ideology. For more about neoliberal politics and healthcare reform please see Dr Clive Peedell’s blog. I believe, like Virchow that,
“Medicine is a social science and politics is nothing else but medicine on a large scale. Medicine as a social science, as the science of human beings, has the obligation to point out problems and to attempt their theoretical solution; the politician, the practical anthropologist, must find the means for their actual solution”.
Most of my posts are about the relationships between GPs and patients and how health policy impacts on that. I am also a NIHR (National Institute for Health Research) In Practice Research Fellow studying moral development in medical education and clinical practice and I use the blog to test my ideas which will be used to inform my research. My main interest is in the use of narrative to illuminate patient and professional values. Ed Piele on Value Based Medicine and Havi Carel on Epistemic Justice are good starting points.
As well as criticising present reforms I’ll be adding suggestions for alternative reforms, which are most definitely needed to improve the quality, efficiency and humanity of care in the NHS.
I’ve been most recently inspired by US Surgeon and writer Atul Gawande, Dutch Philosopher Anne-Marie Mol, British GP and writer Julian Tudor Hart, Academics Colin Leys and Allyson Pollock and British campaigner and retired doctor Wendy Savage.
Conflicts of Interest.
I belong to Keep Our NHS Public and I was a member of their steering committee, but resigned when my young children needed more of my time. I joined them in 2009 and I still give them £50 a month. They need every penny they can get. I also donate £50 a month to the Centre for Health and the Public Interest who publish papers and blogs about health policy. I belong to the British Medical Association and I pay them a membership fee every year. I belong to the Green party because they stand for social justice above and beyond any of the other parties. I also belong to MEDACT who campaign for global justice for health.
Everything on here I have written without payment of any kind, in my spare time. Usually at night when my family are asleep. I have never received any money from any individual or organisation for campaigning for the NHS.
In June 2011 the London Review of Books paid me for writing an article for them. It is available to subscribers here. It is the only payment of any kind I’ve had for trying to keep the NHS public.
In the last year, the topic of my posts has changed to explore the nature of the doctor-patient relationship, which I believe to be precious and under particular threat.
Medical Advocacy Doctors are the natural advocates of the poor, but have little training about advocacy. This needs to change
Kindness in healthcare Kindness in healthcare is in grave danger of being lost. This blog examines the culture of healthcare and suggests how we can bring kindness back.
A Perfect Storm: Welfare meets healthcare Poverty, illiteracy and isolation are at least as great a threat to health as what we consider to be diseases
Loneliness. How doe lonely patients present to medical professionals and how does loneliness impact on care?
Shame. Why do patients and doctors feel ashamed? How does it affect care and relationships between patients and medical professionals?
What’s in a name? Patients, Clients and Consumers Why are we looking for new names for patients?
Love, Hate and Commitment. Why are these things such an enduring and important part of medical care?
Narrative, Forgiveness and Listening. What can the forgiveness teach us about how to listen to the stories our patients tell?
Confessions: Hearing our patients’ stories When we fail to hear the stories our patients are trying to tell us we may miss the diagnosis
Do the justifications for NHS reform stand up to scrutiny? Is there any evidence for the government’s justifications for the Health Bill?
Competition in Healthcare, the risks What are the dangers of increasing competition in the NHS?
Conflicts of Interest and NHS reform In whose interests are the NHS reforms?
What is the point of patient choice? Why is patient choice so controversial? Are doctors really against patient choice?
The cost of chronic disease and the lack of NHS reform Why is healthcare so expensive and why does the Health bill do nothing about it?
Who is the NHS for? Not me! Why are we so divided in our love/ hate relationship with the NHS?
Henry Sigerist and NHS reform What is the history of healthcare reform?
A better NHS. What do we need to do to improve the NHS?
Contact: echothx at gmail dot com