Early spring brought atrocious weather, The Beast from the East mingled with Storm Emma, putting pressure on public services across the board. It has illustrated again how much on the cusp such services are performing, particularly the NHS, as additional pressures could barely be accommodated.

In the real-life drama that is associated with such pressures comes the case of Dr Bawa-Garba being convicted for manslaughter due to gross negligence, of the 6 year old child Jack Adcock. There has been a huge outcry as a single individual has been held responsible for what was clearly a systems failure. Dr Bawa-Garba was working as the sole paediatrician, responsible across three clinical areas, due to rota deficiencies. Additionally, her interaction with both a senior paediatric registrar and the consultant on call, resulted in no change in management being advised. Further disquiet has occurred as to the use of self-reflection documentation, which in this case was used against the doctor, as she had honestly indicated she could have done better.

Such is the concern at the court’s decision in this case that crowd funding has been instituted to pay for a formal appeal against the conviction. This is what natural justice demands but for the longer term more is required. It is required of politicians and our senior managers. Required to cease telling the public that all is well, stop the misinformation that more money is being poured in when it is mostly catch up or existing money, reallocated. No wonder, for the first time in decades, there are unfilled medical school places, which went to clearing, and up to 20% of foundation doctors are looking to emigrate! If this is coupled with the loss of our European colleagues due to Brexit, I see cases such as Dr Bawa-Garba’s, occurring more frequently.

This issue is packed with topics that confirms that Medicine is truly the “Noble Art” and that despite the current political and legal travails doctors, high ethics demands that they always do their best for patients. Successive governments have managed to undermine not just medicine but also primary dental care so Arora and Yeung provide a timely overview of the GP’s role in dentistry (p.6). The genome has been the rage for some years and Shantikumar and his colleagues’ contribution focuses on its value in primary care (p.14). Diabetes continues to be a major public health conundrum, whose prevalence is increasing despite all the efforts of government health initiatives. Hence, the complications of long term diabetes are going to be encountered more frequently by the GP and the article by Mohamedali and Gnudi, provides a neat resume of one such long term problem, diabetic nephropathy (p. 35). Parents worrying about growth issues in their children are frequent visitors to the doctor and Craig and colleagues give an insight on the sorts of issues the GP needs to be aware of and address (p. 47).

By the time this issue reaches you I hope the weather will be much improved and you are enjoying the shoots of a late appearance of the English springtime.


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