A Short History of NICE
(Senior Fellow at the King’s Fund)
Comment by Sir Michael Rawlins.
Nicholas Timmins and Sir Michael Rawlins, the authors with John Appleby of A Terrible Beauty: A Short History of the National Institute for Health and Care Excellence describe its origins and past and the challenges it currently faces.
Professor Sir Michael Rawlins was chair of NICE from its foundation until 2012. Nicholas Timmins is a Senior Fellow at the King’s Fund.
Thursday, 3rd of November 2016, at 5.30 pm
Venue: John Snow A, Keppel Street Building
A blog on the lecture by Virginia Berridge is now available here.
Disease on Trial: the Courts, the Lawsuit and the Public Negotiation over Responsibility for Disease
Professor David Rosner
(Ronald H. Lauterstein Professor of Sociomedical Sciences and Professor of History at Columbia University, and Co-Director of the Center for the History and Ethics of Public Health at Columbia’s Mailman School of Public Health.)
Thursday, 20th of November 2014
Abstract: Over the past twenty years a vast public negotiation has taken place over the causes of, and responsibility for, disease. For the most part this discussion has flown under the radar of doctors, historians and public health professionals. To the extent they have participated, professionals and scholars have been called in as “experts”, as witnesses, to be either listened to, or rejected, by juries and judges. This talk will look at a number of cases over the course of the past two decades that the speaker has participated in. The paper will place his experience in the context of a much longer history of how courts have been used and abused in a contentious struggle over the health of working people and consumers faced by occupational and environmental dangers.
Biography: David Rosner is Ronald H. Lauterstein Professor of Sociomedical Sciences and Professor of History at Columbia University, and Co-Director of the Center for the History and Ethics of Public Health at Columbia’s Mailman School of Public Health. He has published widely on the history and the politics of occupational disease and industrial pollution, including most recently “Lead Wars: The Politics of Science and the Fate of America’s Children,” (University of California, 2013). He has been actively involved in lawsuits seeking to hold the lead industry accountable for past public health harms, and his work has also been part of suits on behalf of asbestos workers and silicosis victims.
How much VD was there in Georgian London? Can we estimate the population prevalence of STIs before the twentieth century?
Professor Simon Szreter
19th November 2013
The venereal diseases feature strongly in Boswell’s diary and consequently Georgian London has passed into literature and popular history as a byword for sexual licence. But is this at all justified as a general description of the capital and its population? Can we hope to know anything about the population prevalence of STIs in Britain before the twentieth century?
Simon Szreter presents new research undertaken in collaboration with Kevin Siena (author of Venereal Disease, Hospitals and the Urban Poor. London’s Foul Wards 1600-1800)
Escaping Melodramas: Retelling the histories of the U.S. Public Health Service STD Research Studies in Tuskegee and Guatemala
Professor Susan Reverby
(Wellesley College, USA)
20th March 2013
Bioethics is often thought of as having been “born in scandal and raised in protectionism.” Less often acknowledged is that bioethics has been so nourished by melodramatic historical frames and paradigmatic stories that the effort to provide a different form of analysis has been problematic. Using examples of the author’s scholarship on the history and coverage of the United States Public Health Service’s untreated syphilis study in Tuskegee (1932-72) and its sexually transmitted diseases inoculation research studies in Guatemala (1946-48), these histories of medical malfeasance, governmental over-reach, and the use of racist and imperial power are examined for the limitations of emotional understandings of “bad scientists” and failures to obtain consent. It is argued that these two tragedies, which have provided an explanation for suspicion of medical and public health research, need to be understood in the context of research hubris and institutional power, not merely as melodramatic tales from the “bad old days.”
The NHS as an unsustainable legacy cost? Patient rights and the duties of doctors and the state, 1720s to 2000s
Professor Steven King
(University of Leicester)
9th November 2011
At a time when the Government is seeking to redefine the role of doctors in health care commissioning, subsidiary budget holders faced by the prospect of financial meltdown are seeking to pare back treatments regarded as ‘rights’ by some sections of the British population. Meanwhile public health initiatives long regarded as ‘obligations’ on the part of locality and state are being undermined. We can therefore see that the question of rights and duties remains a thorny issue at the heart of our health care system. This lecture will take a long term view of the evolution of notions of the rights of the patients and the duties of doctors and the state. Ranging between the 1720s (when arguably the rights of patients and the duties of doctors first became an issue as doctoring moved down the social scale) to the 2000s (when financial constraints mean that we might have to redefine the very concepts of right and duty) the lecture will embody two central arguments: Firstly that modern popular understandings of rights and duties are deeply embedded from the earliest trickling down the social scale of health care options; Second, that the 200+ year mould of patient rights and analogous duties for the state and medical professionals will inevitably be broken as our healthcare system comes to look increasingly like a ‘legacy cost’ in an evolving shift of global economic power.
Return to Deadlock? Health-Care Reform in America
(University of Princeton)
8th February 2010
After nearly a century of failure, the struggle for universal health care in the United States seemed to be on the verge of a breakthrough in December after the Senate and House of Representatives passed separate, though similar, bills that would extend coverage to a projected 95 percent of the population. But the loss of a by-election in Massachusetts in January has probably killed the chances of significant reform. That reform came so close to enactment in 2010—as it did at several earlier times—reaffirms the view that the absence of universal health care in America is not due to deep cultural or structural factors, but to contingent political decisions and the specific developmental path of American institutions. Yet if reform is dead in 2010, it will probably be very dead for a very long time, with the result that inequalities in health care are likely to increase to even higher levels than at present.
Framing the Framingham Heart Disease Study
Professor Gerald Oppenheimer
(City University of New York and Mailman School of Public Health, Columbia University)
11th November 2010
Following World War II, the search for the causes of coronary heart disease (CHD), the leading cause of death in the United States and Great Britain profoundly changed the purview of epidemiology, shifting its primary focus from infectious disease to chronic disorders. When CHD epidemiology is presented historically in the U.S., it often becomes the story of the successful, long-running Framingham Heart Disease Study, initiated in 1947. Framingham becomes a kind of “founding myth,” a New England town in which altruistic, white, ethnically diverse citizens, forward-looking local doctors, and a group of intensely curious physician-scientists cooperate to tease out the causes of epidemic CHD. This act of historical simplification leaves in Framingham’s shadow the other significant cohort studies begun in the 1940s and 1950s, and the generation of CHD studies and clinical trials that followed. It misrepresents the missteps and contestations that are part of any scientific endeavour, especially the debates over the role of risk factors (a term coined by Framingham) and whether any actually caused heart disease and were therefore vital to its prevention. At least as important, it masks the central role of federal public health policy which created and funded Framingham and without which a CHD epidemiology of cohort studies and multi-centre clinical trials would not have existed.
‘Can We Eraducate Malaria? Lessons From the WHO Malaria Eradication Campaign of the 1950’s and 60’s’
(Johns Hopkins University)
5th November 2009
This talk examines the challenge of eradicating malaria by drawing lessons from the earlier WHO led Malaria Eradication Programme of the 1950s and 60s. It suggests that while current malaria control and elimination efforts differ in significant ways from those of the earlier campaign, there are some marked similarities, which raise questions about the feasibility of eradication as a strategy, particularly in Africa.
“The Bevan-Morrison debate: the shape of things to come in the NHS?”
Professor Rudolf Klein
12 November 2008
Ruldolf Klein is a distinguished policy analyst and commentator on the British health services, and his history of the NHS is now in its 5th
edition (The new politics of the NHS: from creation to reinvention). His lecture tackled the issue of central/local relations, from the inception
of the service to the ‘new localism’ of today.
‘The Stress of Life: Hans Selye and the Search for Stability’
(Director, Centre for Medical History, University of Exeter)
21st November 2007
Since the mid-20th century the notion of stress as a determinant of chronic disease has found acceptance both within psychology and clinical allergy, and within popular culture. The vocabulary of stress has thus achieved a powerful presence in everyday speech as a means of explaining the impact of work, personal history and emotional experience on health. The syndrome which came to be known as ‘stress’ was first described in 1936, by the Hungarian scientist Hans Selye (1907-82). This lecture explores the development and reception of Selye’s theories within the context of post-second world war concerns about international political stability and Selye’s own struggles for personal stability. It then evaluates the legacy of Selye’s formulation of the aetiology of chronic disease.