The Model-Driven Hospital

The Model-Driven Hospital By Lord Ara Darzi Modern hospitals are hugely complex, with thousands of staff delivering sophisticated care, often to extremely sick patients. They employ the most advanced technology and equipment and can cost £1 billion a year to run. Although the standard of care delivered in the NHS is the equal of any…

Built in a Day?

By Steve Allder As the Romans used to say, “Qui tacet, consentit.” So while I feel ambivalent about writing, it is better than silently accepting the status quo. Despite the current crop of bad-news stories, I do not doubt the NHS’s incredible value at home and abroad. Its longevity and ability to preserve the ideals…

The Fourth Quadrant

Former United States Secretary of Defense Donald Rumsfeld structured our knowledge into known-knowns, known-unknowns and the famous unknown-unknowns, inadvertently providing a great framework for health. For some reason, he missed the unknown-knowns, presumably the things we don’t know, but that others do. This Fourth Quadrant is the big challenge in healthcare – we can’t do…

An Apple A Day

Isaac Newton’s afternoon under an apple tree shook many ideas, not least our understanding of inertia which, it turned out, was not what brought everything to a halt, but the magical something that kept things as they were until something else stopped them or sped them along. Eventually, he wrapped it up with the bit…

Some like it Blac

In the late seventeenth century, London’s coffee houses drew in thinkers and launched marine insurance, the Stock Exchange and auction houses. Meanwhile, physicians consulted, wits and writers debated, and there was thinking space for scientists.[1] I was reminded of that scene when I was a guest at Café Blac in Glenferrie Road, Melbourne, where 30…

The Wait

Two decades ago, you took a book and a thermos into A&E and waited; ten years ago, a patient complained to me that he had been seen so fast he had not been able to read his book at all! Now people prepare to sit it out, charging their smartphones and buying a coffee, as…