Inadvertent Patient Harm: doctors, managers, medical education, patients, public, policy makers

Patients’ Emancipation: Towards Equality. Charlotte Williamson. Please see flyer, review etc two pages back. Details and review also on Amazon. Clear, well-structured information and suggestions for healthcare modernisation to benefit providers and patients.

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Overdiagnosis and climate change

“Tackling overdiagnosis takes on a new urgency in the context of climate change.

At the extreme end of low value care is no value care—otherwise known as overdiagnosis. Overdiagnosis is the detection of harmless conditions that could be safely left undiagnosed and untreated.23 Once diagnosed, however, a cascade of tests and treatment usually follows, which will not benefit patients who were not unwell to start with…”

Overdiagnosis is increasing the carbon footprint of healthcare. Alexandra Barratt, professor of public health, Forbes McGain, associate professor. (Published 04 October 2021).

BMJ 2021;375:n2407

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Book review: Patients’ Emancipation: Towards Equality by Charlotte Williamson

This remarkable book had an immediate impact on me.

As a patient activist aiming to improve health services, useful information had often been too difficult to obtain. I had felt like a lone voice pushing against brick walls, as controlled and disenfranchised as women from an earlier age who sought voting rights.. Sometimes there seemed to be a deliberate ‘Them and Us’ policy which kept patients in their place to prevent upsetting the status quo. Genuine patient centred care seemed an unobtainable goal.

Over the following years, although official policy directed healthcare providers towards patient-centredness and doctor-patient groups brought joint working, even small improvements came slowly and often melted away as personnel changed roles.

However, increasing numbers of patient representatives worked alongside health professionals at national level which fostered understanding, mutual respect and trust. Sadly, this was not the case countrywide.Despite apparent acknowledgement of the need for change, there were often plenty of words, but no deeds; tantalising improvements dissipated like scorched summer mist, while patients’ poor experiences of healthcare illustrated that patient harm, even if inadvertent, continued to occur. Why?

As I turned the pages of this important work, I realised why it felt like the final missing piece of a jigsaw puzzle. It was precisely what had been needed for so long, and the key to achieving patient centred healthcare modernisation.

This brave book not only discusses how unintentional patient harm can be caused by doctors, and even managers, but dares to suggest how improvement and change can be achieved.  

The well-structured, rich content explains the author’s theory of the need for patients’ emancipation, while clarity of thought and reasoned argument backed by a wealth of examples and detailed information all lead in planned sequence to the final chapter, Chapter 7. This includes stress that doctors experience as well as steps that ‘interest holders’ such as patients, doctors and managers can take to help patients’ emancipation. 


We are all potential patients, so this remarkable book could be useful for everyone. It would not be an over-statement to say this superb work not only deserves to be an essential part of medical education, but also recognised as an important foundation for modernising patient-centred care.

Mitzi Blennerhassett

You can download the promotional flyer here.

Or read ‘The Radius’ review here.

Buy direct from the publisher by emailing or by calling 01904 635967

Or buy from here.


Patients’ Emancipation:

Towards Equality

Charlotte Williamson
Published 2021 ISBN 978-1-912728-36-7
Softback: 170 pages printed on 100gsm bookwove, chosen for its sustainabilty.

“An engaging and interesting argument around the thought that patients are subject to a subtle form of oppression that they haven’t actually realised is in existence. The narrative will undoubtedly intrigue a wide audience. The work is well-structured, allowing the story to build progressively into a multi-layered scenario of relatable events and circumstances, leaving the reader hungry to continue reading.”

Jessica Kingsley, Publishers.

“It provides both an academic and an experiential insight.”

Professor Rob Baggott, Professor of Public Policy at De Montfort University.

Bafflingly, in spite of their good intentions, doctors and managers can sometimes harm patients. Thisharm ranges from major instances of bodily damage, like those reported in the Cumberlege Review of 2020 and the many ‘hospital scandals’ before it, to minor instances of inconsiderate or patronising behaviour. But neither doctors nor patients are usually aware of what lies beneath these distressingactions. What can explain this? The author’s emancipation theory, drawing on social, structural, andpersonal factors, can.  This book develops that theory, illustrating it with everyday examples. It offerspatients themselves, doctors and managers ways to work towards emancipating patients from oppressive attitudes and unjust restrictions.

Preface and Acknowledgements

Chapter 1     Introduction to patients’ emancipation

Chapter 2     Patients take action :  ideas and principles

Chapter 3     Patients specialise : roles and relationships

Chapter 4     Doctors respond

Chapter 5     Enter managers

Chapter 6     The political trio: patients, doctors, and managers

Chapter 7     Concluding thoughts : a new model?  

Postscript    The corona-19 pandemic



Patients’ Emancipation: Towards Equality

£15.00 includes p&p   ISBN 978-1-912728-36-7

obtainable direct from the publisher Quacks Books:

Quacks Books, 7 Grape Lane, Petergate, York YO1 7HU

E:    T: 01904 635967    or visit:

through your local bookseller, or via

Softback: 170 pages printed on 100gsm bookwove, chosen for its sustainabilty.

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Covid-19 vaccinations – British Medical Journal article

‘Primary Care can do it, but needs extra support to do it fast, safely and effectively’ say Professor Azeem Majeed and Mariam Molokhia writing in the bmj 30 November 2020.

For anyone wanting to know more about the Covid-19 vaccine being offered to the UK public, the Rapid Responses to this article (currently numbering 29 and, like the article, all with free access to the public) offer interesting information and flag up several concerns, not least openness, patient/person safety and informed consent.

Vaccinating the UK against Covid-19. Majeed A, Molokhia M. BMJ 2020;371:m4654

Posted in covid19, Critical thinking, death, ethics, harms, informed consent, patient safety, personal autonomy, Public safety, vaccination programmes, vaccines | Tagged | Leave a comment

Government Advisers’ Conflicts of Interest hidden

‘…the government has faced mounting questions about procurement decisions, from personal protective equipment to testing kits, from vaccine deals to the services of logistics companies.’

Conflicts of interest among the UK government’s covid-19 advisers. Paul D Thacker

(Published 09 December 2020) BMJ 2020;371:m4716

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Reducing bias and improving transparency in medical research; a critical overview of the problems, progress and suggested next steps

A review in the Journal of the Royal Society of Medicine by Bradley et al around problems that have undermined trust in medical research in recent years outlines some of the most important issues: research culture, reporting biases, and statistical and methodological issues. It examines the success and limitations of measures that have been instituted to address these problems and suggests ways of achieving significant improvement which include a public campaign about which it invites readers’ feedback and participation.

Reducing bias and improving transparency in medical research; a critical overview of the problems, progress and suggested next steps. Bradley S H, de Vito N J, Lloyd K E, Richards G C, Rombey T, Wayant C, and Gill P J. JRSM; 2020, Vol 113(11) 433-443

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From the Bad and Sad Came Forth Sweetness and Humour

Covid is not all doom and gloom. The School House Gallery, York, started a project


‘asking people to share their ideas of ‘home’ during the global pandemic.’


I was amazed when they accepted the verses I sent in and delighted to see them posted in the online gallery.

This is the gallery of contributions mainly paintings, photos, sculpture and ceramics– it’s continuously evolving so keep checking back – and keep scrolling, as there’s lots here. I don’t know how long they will be accepting contributions.

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Breast cancer, screening, health checks and fake disease

So you think screening saves lives? This video is so good perhaps I should be posting it once a month – or once a week – or every day! For anyone who wants to know more about screening, health checks, overdiagnosis, lead time bias, with how and why what seems like a good idea can actually cause more harm than benefit – from the horse’s mouth –

This video is so good, perhaps I should be posting it every month, or every week, or even every day. It’s what we all need to know about screening and health checks – from breast screening and DCIS to having your life ‘saved’.

The epidemic of Fake Disease:

Posted in Campaigns, cancer, citizen safety, Compassion in healthcare, Critical thinking, DCIS, death, diagnoses, ethics, evidence-based medicine, guidelines, harms, healthcare modernisation, information, informed consent, mastectomy, medicine's flaws, openness, Over-medicalisation, overdiagnosis, overtreatment, patient safety, personal autonomy, prostate cancer, psychological harm, Public safety, Screening, screening prostate cancer, speaking out, transparency, unethical payments, unsolicited appointments, unsolicited mail | Tagged , , , , | 2 Comments

Breast cancer: Blatant disregard to proper consent continues in screening programmes

‘The healthcare system is disjointed, siloed, unresponsive, and defensive.’

‘Cumberlege review exposes stubborn and dangerous flaws in healthcare’ writes Helen Haskell (BMJ 2020; 370:3099). The Independent Medicines and Medical Devices Safety Review (IMMDSR) was carried out by Baroness Cumberlege and looked into patients’ reports of harm from two drugs and one medical device: Primodos, sodium valproate and pelvic mesh. Serious shortcomings were found in the marketing and oversight of the three treatments as well as the patients who raised concerns.

Hazel Thornton’s rapid response (7 August, 2020) picks up on the review’s point of informed consent: ‘Perhaps most striking was the testimony from hundreds of patients reporting lack of informed consent for their initial treatment, followed by years of dismissal by clinicians and regulators who did not want to associate life-altering symptoms or injured children with their medical interventions’ and highlights that it is not only patients, but (asymptomatic) citizens who are targets of health professionals in preventative medicine, ie breast screening and the (known harms of the) AgeX Trial. – My parentheses.

Emma Friedmann’s blistering response questions the BMJ’s role regarding concerns raised by the review.

It is to be hoped that the 9 recommendations of the IMMDSR will be swiftly implemented.

Posted in Breast Cancer, breast screening, Campaigns, citizen safety, Compassion in healthcare, DCIS, diagnoses, dying, ethics, harms, healthcare modernisation, informed consent, medical devices, medical implants, medicine's flaws, medicines, openness, overdiagnosis, overtreatment, patient safety, patient/doctor communication, personal autonomy, psychological harm, Public safety, Screening, Screening Mammography, speaking out, transparency, unethical payments, unsolicited appointments, unsolicited mail | Tagged , , | Leave a comment

Second reading of Medicines & Medical Devices Bill

Second reading of Medicines and Medical Devices Bill in the House of Lords –

See esp Lord Blencathra at 6pm

I begin by paying a warm tribute to my noble friend the Minister. He is one of the finest Ministers I have encountered in this House: intelligent, knowledgeable, on top of his brief, courteous and very hard-working. I am delighted that he is going to listen to the criticisms on delegated powers today. Thus it grieves me to say that the structure of the Bill is absolutely atrocious and an affront to parliamentary democracy. Of course, it is not unique; it is just one more Bill stuffed full of Henry VIII clauses but devoid of substantive content. It is the barest skeleton, all to be filled in with negative secondary legislation. I am speaking in my capacity as chair of the Delegated Powers Committee. We considered the key clauses—Clauses 1, 8 and 12—and concluded that they contain inappropriate delegations of power…. etc

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