Medical Journal News

“I don’t feel guilty. I don’t feel I’ve dishonoured the profession, and I think I could explain myself very well to anybody who thought that I had,” says Sarah Benn, climate activist and former general practitioner.Fresh from the decision by the UK’s Medical Practitioners Tribunal Service (MPTS) on 23 April to suspend her from the professional register for five months,1 she finds the situation clear: the activism that led to her suspension was necessary to raise the alarm over the climate crisis and was also in keeping with a doctor’s mission to promote health and save lives.“The world is facing an unprecedented crisis due to the danger of climate and ecological collapse, and I believe that my actions are a justified and proportionate effort to raise an alarm about the severity and urgency of the situation,” she says. “All the science is absolutely shocking—the planet is on a path to...

The BMJ has recently published two articles that acknowledge an important elephant in the room of NHS funding.12Appleby and colleagues point out that, to secure the future of the NHS, decision makers and the public need to make choices about what the service should spend its finite resources on.1 In their editorial McCartney and Craig, this time referring to Scotland’s NHS, remind us that these choices need to focus on helping us to reconcile the imbalances in supply and demand.2The elephant that is slowly coming out of the shadows has a name—rationing.The choices that must be made are difficult. Some treatments and services will be prioritised and others will not—that is, they will be rationed. It is remarkable that the stark and uncomfortable consequences of these choices were not explicitly named in these articles.Without acknowledging that rationing is one of the uncomfortable and difficult consequences of balancing supply and demand...

A decision by the drug manufacturer Moderna to drop plans to set up its first mRNA vaccine manufacturing plant outside the United States in Nairobi, Kenya, should be seen as a wake-up call to developing countries to increase their investment in vaccine and drug development, an expert has said.Madhukar Pai, a Canada research chair in epidemiology and global health at McGill University’s School of Population and Global Health, said that it was “a huge mistake” for African nations to rely on the drug industry.Pai told The BMJ that Moderna’s “U turn on manufacturing in Africa was not a surprise to anyone” given the company’s reluctance to share vaccine technology despite getting public funding, as well as its prioritisation to supply covid vaccines to rich nations over low and middle income countries.Moderna announced last month that it was halting plans to set up the facility in Kenya’s capital, which was poised...

The asthma drug montelukast (Singulair) will carry more prominent warnings in the UK to alert doctors and patients to its potentially serious behavioural and neuropsychiatric side effects.Previously noted side effects associated with the oral treatment include sleep disturbances, depression, and agitation (which may affect up to one in 100 people); disturbances of attention or memory (up to one in 1000); and hallucinations and suicidal behaviour (up to one in 10 000).After reviewing the risks associated with the drug and awareness of the side effects1 the UK Medicines and Healthcare Products Regulatory Agency (MHRA) published the new advice. It said that while the risks remain unchanged, reports have indicated that side effects are potentially not well known by clinicians and patients, and that clearer warnings are needed.Latest data from the Yellow Card scheme show that MHRA received 1282 reports of suspected neuropsychiatric adverse drug reactions to montelukast between 1998 and the...

The working conditions of doctors in training have had a brief moment in the spotlight following a recent letter from NHS England (NHSE) to NHS trusts urging measures to improve our working lives.1 While it’s encouraging to hear a call for nationwide action to tackle the challenges facing doctors in training, this letter is only a small first step to achieving that goal.The letter, sent by NHSE’s chief executive Amanda Pritchard, lays out several action points for hospital boards. It includes welcome recommendations to reduce the time burden of statutory mandatory training, increase attention to payroll accuracy, and improve rota management and deployment. NHSE’s commitment to monitoring compliance with rota regulations and providing intensive support to payroll teams is also promising. Many trainees will have experienced the mental and emotional drain of having to argue over unfair parking charges or payroll errors or dealing with financial pressures caused by waiting...