Medicine and Science from The BMJ

This week we’re focusing on the NHS. On the 3rd of July the UK’s Prime Minister, Kier Starmer finally announced the NHS’ 10 year plan. His Labour government laid out a vision for where the healthcare service should head over the next decade. The announcement has been met with mixed responses. The plan has some good ideas - but a lack of vision combined with scarcity of detail leave many questions about how well its aims can be implemented. In this podcast we're joined by 3 experts to dissect the details of this plan Jennifer Dixon is chief executive of the Health Foundation Katie Bramhall-Stainer is a working GP, and chairs the BMA’s General Practice committee. David Oliver is a consultant geriatrician, and a columnist for the BMJ Reading list News analysis: What is the NHS 10 year plan promising and how will it be delivered? Editorial: Government’s 10 year plan for the NHS in England David Oliver's column: The NHS 10 year plan—more a set of ambitions than a plan

Tom Dolphin, a consultant anaesthetist and the new chair of the BMA Council, discusses his vision for empowering union members and addressing NHS challenges. He highlights the importance of localized medical representation and ongoing pay disputes, emphasizing the need for better working conditions. Dolphin also dives into the workforce crisis, the plight of international medical graduates, and the necessity for advocating trans rights in healthcare. His passion for unity and respect in the profession aims to foster a better environment for both doctors and patients.

Last December, The BMJ published an investigation into the 2009 PLATO trial - exposing serious problems with that study’s data analysis and reporting.  Our follow up investigation has shown that those data problems extend to other key supporting evidence in AstraZeneca’s initial application to regulators. Peter Doshi, senior editor in the BMJ’s Investigations unit, and Rita Redberg, cardiologist and Professor of Medicine at UCSF and former editor of JAMA Internal Medicine, join us to explain what this means for scientific integrity, and trust in the FDA's approval processes.   Also in this episode. A group of international authors are arguing that weightloss advice given in primary care might actually be doing more harm than good - it’s ineffective and potentially reinforces damaging stigma.  To explain why they came to that conclusion we're joined by Juan Franco editor in chief of BMJ EBM, and a practicing GP in Germany, and Emma Grundtvig Gram, from the Centre for General Practice at the University of Copenhagen Reading list Doubts over landmark heart drug trial: ticagrelor PLATO study Ticagrelor doubts: inaccuracies uncovered in key studies for AstraZeneca’s billion dollar drug Beyond body mass index: rethinking doctors’ advice for weight loss

The rising concern of ketamine addiction among UK youth takes center stage, with experts discussing its dual role as both a recreational and therapeutic drug. The podcast critiques the UK government's proposal for hospital league tables, warning that linking performance to outcomes may harm genuine healthcare quality. Experts share insights on how such rankings can create accountability issues and erode clinical autonomy, stressing the need for a more supportive approach in healthcare management.

Devi Sridhar, a Professor of Global Public Health and author, discusses the myths propagated by wellness culture and its failure to consider societal factors affecting health. She emphasizes the urgent need for systemic policies to improve life expectancy amid rising health issues. John Downey from the Centre of Health Technology shares insights on Portsmouth’s 'Living Lab,' aimed at testing real-world applications of health tech. The duo critiques the misleading nature of wellness trends on social media and explores the transformative potential of AI in preventive healthcare.

Gordon Guyatt, a distinguished professor at McMaster University and co-founder of the GRADE system, discusses the complexities of evidence evaluation, advocating for a simpler approach called Core GRADE. Zulfiqar Butta and Sanjay Nagral, co-chairs of The BMJ's South Asia editorial board, highlight the health impacts of escalating tensions between India and Pakistan, emphasizing the need for nuclear disarmament and focusing on citizens' health needs. Chris Zielinski calls for the WHO to renew its nuclear war impact assessments, framing health as a cornerstone of peace in the region.

Join Regina Rabinovich, a malaria elimination expert, as she reveals how China achieved malaria-free status through innovation and persistence. Hui Liu discusses the implications of retracted studies on clinical guidelines, stressing their alarming influence on healthcare practices. Sonia Saxena advocates for a revolution in academic medicine, focusing on curriculum reforms and the need for integrity in research. Together, they outline the importance of collaboration in overcoming global health challenges and transforming medical education.

The UK government is debating legislation to allow assisted dying in England and Wales, which puts doctors at the forefront of deciding if their patient will be eligible for a medically assisted death - the key criteria being a 6 month prognosis. But is making a 6 month prognosis actually clinically reliable? To discuss we're joined by a panel of experts on end of life; Scott Murray, emeritus professor of primary palliative care at the University of Edinburgh Simon Etkind, assistant professor of palliative care at the University of Cambridge Nancy Preston, professor of supportive and palliative care, Lancaster University Suzanne Ost, professor of law, Lancaster University Reading list Assisted dying and the difficulties of predicting end of life Breaching the stalemate on assisted dying: it’s time to move beyond a medicalised approach   Also in this episode, we dim the lights and raise the curtains - there is a public fascination with doctors who kill and the stage show turned podcast, ‘An Appointment with Murder’, takes a deep dive into the crimes of GPs John Bodkin-Adams and Harold Shipman. Kamran is joined by Harry Brunjes and Andrew Johns to talk medical murder. An Appointment With Murder on Apple Podcasts    

Kamran Abbasi interviews Professor Ashish Jha, Dean of Public Health at Brown University and former COVID-19 pandemic advisor to President Biden. Watch this interview on our YouTube. Trump’s second term has touched everything in the US political sphere - and health is no exception. With research funding for medicine and science weathering under Trump’s storm of cuts, how can Americans who care about public health and data navigate a course through the swells? Professor Jha discusses how to resist an anti-vaccine resurgence, and comments on revisionist narratives that drive ill-conceived public health policies.   02:20 The MAHA movement and RFK Jnr. 07:40 Does evidence still matter? 13:35 Trump administration is helping China 15:10 Policymaking in Trump’s shadow 23:35 Where do universities go from here? 28:48 Censorship, research funding and academic freedom 33:35 Health inequalities within America 36:20 A resurgent anti-vax message 41:24 What Ashish’s got wrong about the pandemic response 45:31 When is enough for research data? 47:14 Future hope and how to pushback in smart ways   Reading list: Professor Jha’s December 2024 editorial on the Trump admin’s plans for American healthcare coverage 

The UK’s chancellor has announced a £5bn cut to benefits, much of which will be borne by those on long-term disability allowance. Gerry McCartney, professor of wellbeing economy at Glasgow University explains about why these cuts will not only hurt the most vulnerable, but will be counterproductive to the government's wish to get people back to work. Also, Suzanne O'Sullivan, consultant neurologist and author, joins us to talk about her new book "Age of Diagnosis". The book used clinical cases to explore the issues of medicalisation, and Suzanne explains why overdiagnosis doesn't mean that care isn't needed.   Reading list; UK welfare reforms threaten health of the most vulnerable Guardian edited extract from "The Age of Diagnosis: Sickness, Health and Why Medicine Has Gone Too Far"