kabbasi@bmj.comSocial care has had its NHS moment. Andy Burnham’s announcement of a national care service may become historic if he is able to deliver it. His vision will be met with resistance, just as Aneurin Bevan’s announcement of the NHS was received in 1945. The importance of national reconstruction, agreed during the second world war, led to the Beveridge report, which identified “five giants” that needed to be tackled for Britain to succeed economically and socially: “want, disease, ignorance, squalor, and idleness.”1 The five giants have been forced back at various times but they seem to be back on the march.Some commentators observe that the covid-19 pandemic was the other great national emergency of the past 100 years, alongside the second world war.2 The need to build back better and fairer remains (doi:10.1136/bmj.n1677).3 Economist John Maynard Keynes, subject of a new West End play,4 deemed the plans in Beveridge’s report...

AI “has the capacity to dominate us to free us from medical tyranny” US health secretary Robert F Kennedy Jr has claimed.1“It can give you a second opinion that is much better informed than any doctor in the country,” Kennedy told a Make America Healthy Again summit earlier this week.2Kennedy quoted Sam Altman, OpenAI’s chief executive, who reportedly told him in a private meeting days before that it would be “malpractice for a doctor to make a diagnosis or to make a prescription without at least checking AI.”“One of the things that is going to change is that we’re never ever again gonna be dominated by public officials who tell us ‘trust the experts,’” Kennedy said.“If somebody tells you, ‘Masks work, trust the experts,’ AI may tell you otherwise. If somebody tells you, ‘Social distancing works, trust the experts,’ AI may correct that. And if somebody tells you that a...

In 1788, the Birmingham physician William Withering was consulted by an apothecary in Wellington, Shropshire, about the case of a woman, Mrs Houlston, whom Erasmus Darwin’s son, Robert Darwin, a medical practitioner in Shrewsbury, had attended the day before. Withering thought that Darwin’s prescription had been inappropriate and changed it. Robert reacted angrily, and a vituperative correspondence followed. Erasmus, Robert’s father, also medically qualified, may have been involved in the affair, by urging his son to attack Withering and by helping him to write his letters. Erasmus may have had good reason for wanting to damage Withering’s reputation. Although all three of them were alumni of the Edinburgh Medical School in the latter half of the 18th century, albeit at different times, and although Erasmus had recommended Withering to both a post in Birmingham and membership of the Lunar Society, he may have become jealous of Withering’s success as a physician and botanist. The enmity between them had culminated in a dispute over the treatment of a patient in Staffordshire, whom Withering was asked to see after Erasmus had attended her, with little therapeutic success. Withering recommended digitalis, which seemed to have saved her life. Darwin reported the case in 1780, anonymously including it in a posthumous publication credited to another medical son, Charles, and without crediting Withering. In turn, Withering responded by criticising Darwin in his 1785 monograph An Account of the Foxglove. The rift between the two seems to have been irreparable.

Any NHS staff member suspected of improperly and unlawfully accessing patients’ medical records will be immediately suspended, NHS England has announced.Staff under suspicion will also have their access to NHS computer systems cut off, under a “zero tolerance crackdown on snooping staff,” NHS England said.Jim Mackey, NHS England chief executive, has written to every NHS trust demanding they immediately implement the new approach.Staff suspected of accessing patient records without proper justification will be suspended pending investigation and have their access to NHS systems paused.It comes after several cases of staff being caught accessing patient records when they should not have.In May, Nottingham University Hospitals NHS Trust fired 11 staff members and issued warnings to 14 others for inappropriately accessing the medical records of three people killed by Valdo Calocane.1NHS systems keep records on who has accessed patient information, and suspicious activity can be identified through routine monitoring and audits.When inappropriate...

The Galleri multicancer detection blood test has been recommended by the US drug regulator’s expert advisory panel, despite concerns over its effectiveness.The decision by the US Food and Drug Administration (FDA) came a day after results from the NHS-Galleri trial, published in the New England Journal of Medicine, showed that the test had failed to meet its primary endpoint: lowering the incidence of stage 3 or 4 cancers across 12 cancers after three screening rounds.1The FDA panel was split on whether it thought the blood test, which retails for $949, was effective, with six members voting in favour of it being effective and four voting against.2Stanley Lipkowitz, senior investigator at the National Institutes of Health (NIH), who voted no when asked about effectiveness, said that when it came to patient outcomes “we don’t have that data.” He also warned that approving the test without data to prove effectiveness would set...

BiographyCatherine Wang, 23, medical student at Oxford University became The BMJ editorial scholar in August 2026. At medical school, she is the captain of the medics football team, editor in chief of the Oxford Medical School Gazette, and producer for podcast The OxStu Supplement. She is excited, and slightly apprehensive, to be moving from behind the scenes of podcast production to the hosting seat for the podcast Sharp Scratch. This year, she looks forward to giving a platform to a diverse range of perspectives in BMJ Student that she hopes will give everybody something to relate to.What was your earliest ambition?Winning sports day.How is your work-life balance?Pretty good. I’ve started planning more activities into my day, so I’m forced to work in short bursts between. It has done wonders for my motivation.To whom would you most like to apologise?To my brothers, for treating them like my personal search engine.What do...

Every day, clinicians working with young children meet parents worried about paying the rent, buying food, covering childcare costs, and keeping the lights on. Financial hardship affects the health and wellbeing of children and their families.12 Yet many health professionals feel uncertainty about how they should respond, whether talking about money is beyond the remit of healthcare, and what difference they can realistically make.Following Scotland’s pioneering lead in 2010, countries including Australia, Sweden, and England have developed initiatives known as Healthier Wealthier Families. The programmes use healthcare contacts to identify families experiencing financial hardship and connect them with community based financial wellbeing services. Financial wellbeing services are known variously as money advice, financial counselling, budget and debt counselling, or welfare and benefits support.345 By focusing on hardship, they differ from financial advice or planning services, which build wealth.Families consistently report that conversations about money are acceptable in healthcare settings and...

Scotland saw a spike in deaths related to drug use last year—with a fifth of deaths linked to a group of highly potent synthetic opioids called nitazenes.Drug use deaths in Scotland rose by 11% (116 deaths) to 1133 in 2025, figures from National Records of Scotland (NRS) show.1 This means that Scotland continues to have the highest rate of deaths from drug use in Europe.However, the substances responsible for the deaths are changing.In 2025 more than a fifth of deaths (247, 22%) were linked to nitazenes, a class of synthetic opioids that can be hundreds of times more potent than heroin. This was more than triple the number of deaths linked to these drugs in 2024.The NRS noted that etonitazene—the most common of the nitazenes, linked to 215 deaths in 2025—was incorporated into routine testing in postmortem examinations only in May 2025, which may explain the increase.However, the government and...

The proportion of young children in Gaza affected by wasting—a form of severe malnutrition—fell sharply in the months after a ceasefire was announced, a study has indicated.But the nutritional gain documented since more food trucks have been allowed into Gaza “remains fragile,” warned the UN Relief and Works Agency for Palestinian Refugees (UNRWA), which carried out the research.Medical relief organisations on the ground in Gaza said that they were still seeing widespread malnutrition and that much of the food getting in was of poor nutritional value.The study estimated that nearly 16% of children aged 6 months to 5 years in Gaza—more than 54 600 children—were affected by wasting in August 2025.This fell to around 8% in October 2025 when a ceasefire was declared and the number of food aid trucks entering the territory increased.The proportion affected by wasting fell further to about 3% in February 2026 and stayed at this...

In systematic reviews of randomised controlled trials, the established steps are to identify all eligible trials, to appraise them using risk of bias tools, and to synthesise the results to reach a conclusion about the effectiveness and harms of an intervention. This paradigm is threatened by the presence of problematic studies in the literature. As defined by Cochrane, these are studies “where there are serious questions about the trustworthiness of the data or findings.”1 A study could be problematic due to research misconduct (including plagiarism, falsification, and fabrication of data or methods) or due to critical errors in study conduct that would not be flagged by risk of bias tools. If these studies are not identified as untrustworthy, they may inadvertently be included in evidence synthesis, potentially leading to treatment recommendations that are misleading or even actively harmful.234 Because many of these studies are not easily identifiable, it is difficult...

Electric scooters and head injuryA three year retrospective study of emergency departments in Helsinki identified 184 traumatic brain injuries associated with riding electric scooters (J Neurol Neurosurg Psychiatry doi:10.1136/jnnp-2026-338835). Most occurred at night or at weekends. Eighty-two per cent of patients were intoxicated and only 9% were known to have worn a helmet. Sixteen per cent had intracranial abnormalities on imaging and four required surgery.TicklishnessAmong 448 young adults from Chinese, Dutch, and Greek cultural groups, body maps of the most ticklish areas were remarkably similar (Nat Hum Behav doi:10.1038/s41562-026-02535-z). The neck, axillae, abdomen, and soles of the feet were the most sensitive areas. Charles Darwin’s suggestion that parts of the body that are touched least often are the most ticklish looks right, but why ticklishness evolved is still a mystery.The Edinburgh Postnatal Depression ScaleThe 10 item Edinburgh Postnatal Depression Scale has remained unchanged for 40 years and has been translated...

A girl presented with a two day history of bilateral eye irritation and frequent blinking. She had a history of autism spectrum disorder and growth restriction.On examination, her conjunctivae appeared dry (fig 1, top) and there were whitish, foamy lesions in keeping with Bitot’s spots (fig 1, bottom). Visual acuity was normal in both eyes. Retinal appearances were normal on funduscopy.bmj;394/sep24_6/e100205/F1F1f1Fig 1On further questioning, the mother reported that the patient followed a restrictive diet consisting mainly of rice, bread, potato chips, and crisps. Results of serological testing confirmed vitamin A deficiency (<0.35 µmol/L; reference range 1.05 to 3.84 µmol/L).Xerophthalmia is the spectrum of eye disease caused by vitamin A deficiency and can lead to blindness. It typically presents with difficulty seeing in dim lighting conditions. Other typical signs include conjunctival dryness and Bitot’s spots.1Children with autism spectrum disorder are at higher risk of nutrient deficiencies because they may have restrictive...

Over the past 14 years, I’ve been asked to review four major errors in high stakes medical exams: three for UK medical royal colleges and one for the UK Foundation Programme Office.1234 In each of these cases, candidates were given the wrong exam result, with some applicants even receiving an incorrect pass or fail. All the organisations involved responded to me with full cooperation and disclosure and expressed genuine regret and contrition. Nevertheless, some people were severely affected by the errors, and I’ve heard many distressing stories about the personal and professional consequences it has had.These exam errors all shared a few common features, and understanding these can help avoid the same mistakes being repeated. Although almost all the errors were the result of human error; they all happened under conditions where mistakes are more likely.The first vulnerability is information moving between systems, from one software platform to another. Each...

A balanced study of septic shock in childrenProtocols for using sodium chloride 0.9% solution, often called “normal saline,” have changed over the past two decades. In part because of its not so normal levels of chloride that are associated with acute kidney injury. A pragmatic trial across five countries assessed balanced crystalloids (Ringer’s solution, Plasma-Lyte, or Hartmann’s solution) versus 0.9% saline in children treated for septic shock. Despite finding higher rates of hyperchloraemia in the 0.9% saline group, there was no difference between groups in the primary outcome of major adverse kidney events after 30 days.N Engl J Med 2026 doi:10.1056/NEJMoa2601969Extraordinary claims for new stroke treatmentIn theory, neuroprotective and neuroreparative drugs such as loberamisal could improve outcomes from acute ischaemic stroke. Trials of potential neuroprotective drugs, however, have repeatedly failed to find any benefit. “Hundreds of promising agents were tested. The result: failure over and over again” writes an editorial...

F. Gordo Vidal
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