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What I wrote

Most of the stuff I have written is pretty dull stuff. 


- I have included below some which may appeal to those of a less nervous disposition
- Firstly an editorial from the Journal of Public Health?
- Next a piece about inequalities in health



One of my JPH editorials - if you really want the rest, find it at here

When I was in sixth form and in my early days as a medical student I would, every Christmas, take a temporary job delivering letters and parcels. This entailed getting to the Chepstow sorting office by 7 a.m. to get the first van to the post office in a small village called Llantrissant. Here, the postmistress and assistant postmistress would ply me (the van continued on to Monmouth or Ulan Bator or somewhere) with tea and fruit cake until I was fit enough to do my round.

This entailed a walk of about five miles around the more isolated farmhouses in the area, of which there were many. I knew the area a little but needed to be given detailed instructions on how to get to the more remote farms. Some appeared to have no road, simply a slightly marked track across fields. The two at the apogee of my round were Pant Glas and Hygga. I never saw anyone at either farm but simply left my pile of Christmas cards and occasional parcels in the front porch.

One morning, it was freezing cold – the area is over 1000 ft above sea level – when I noticed some activity in the farmyard of Pant Glas. There were three border collies facing me in a semicircle; chests on the ground bottoms in the air; making no noise whatsoever. A fourth then closed the circle behind. I felt no particular concern as I had been here before, though had never previously seen the dogs. However, they showed no obvious signs of aggression other than their body position. I had grown up on farms, though the dogs there, in the soft lowlands, were just for playing with and shouting at, not working ones.

Suddenly a fifth dog came racing from my left across the ring taking a piece out of my left trouser leg and a portion of the calf beneath it and shot on out of the right side of the circle. At this point, I made my apologies and left, as the News of the World used to say; quite fast with my bag to the rear. The dogs seemed to regard this as a result and ignored me.

The moral of the story is that you can worry about tsunamis, SARS, terrorist attacks, bird flu, but it is the one you have not noticed yet that is the bugger.

Inequalities in health

The Marxist who taught me about determinants of health, tried to convince me that the definitions of social class had been set according to the mortality of the occupational group, rather than the other way around. The importance of health in relation to social class, which had always been in the minds of people in public health then called social medicine (well it would be, wouldn’t it).

Edwin Chadwick probably started it all when he published his ‘General Report on the Sanitary conditions of the Labouring Population of Great Britain’ in 1842. This showed that the average age at death in Liverpool at that time was 35 for gentry and professionals but only 15 for labourers mechanics and servants, but I digress. These ideas were again was developed in the Black Report in1980; I have a rare original dark mauve copy, suppressed by Mrs Thatcher with some vigour by publishing very few copies over a bank holiday weekend.  Despite opposition it was published a couple of years later as a Pelican paperback.

Click here for a PowerPoint on international inequalities

If you've got this far, you are obviously a sucker for punishment and might like a piece on 'immaculate misconceptions'. And another on 'values in the NHS.'


 

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The Government have passed a bill making General Practitioners the lead professionals in purchasing the services run by the NHS. The government believe that GPs know what patients want.... But do they know what they need? Interestingly the government have now retracted from their original plans to some extent, so that hospital doctors and other professionals will be involved in purchasing care. Read
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Norman Vetter
Cardiff

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Last edited:  04/04/2012          Copyright 2011 -- Norman Vetter