Abstract
Welcome to the new-look JRSM. Our ambition was to keep it simple, clear and readable, with a dash more colour and life on the front cover. Inside, the words speak for themselves to create a unique mix of content focusing on UK medicine and healthcare.
Indeed, the JRSM has now adopted leading publication policies. Few other journals can offer open access to research articles, open peer review, declarations of competing interests and contributorship statements. These policies have met with a favourable response from authors, with more and more high quality articles submitted. We will further improve our service to authors over this year.
You may be less pleased. if so, do tell us. Is the JRSM an Ostrich, a Lame Duck, Icarus, or a Flamingo? You might consider it in those terms if you adopt the four Mont Fleur scenarios used to understand how South Africa would emerge from the end of Apartheid. Phil Hadridge and Ross Pow believe that these scenarios from 6000 miles away do resonate and provide a useful metaphor and lens to understand the National Health Service today (JRSM 2008;
The ambition, of course, is to achieve Flight of the Flamingos, where policies are sustainable and the service takes a path of inclusive growth and representation. NHS leaders address the failures of confidence, curiosity, connection, and compassion. But a more positive future for the NHS does not come easily, say Hadridge and Pow, since it requires involving everyone in the organisation.
Some managers would argue, though, that doctors are at the heart of the cultural problems of the NHS, exclusive, and insufficiently focused on productivity. Now that Hospital Episode Statistics have become commonly used in England to monitor activity and crude outcomes, health economists from Birmingham and York take the scrutiny of hospital consultants one step further by analysing gender and variation in activity rates (JRSM 2008;
Bloor et al. reach the incendiary conclusion that men have significantly higher activity rates than women, after accounting for age, specialty and hospital trust. The reasons for this gender difference are unclear but the implications for medical workforce planning are important. Feminization of the profession, suggest the authors, could lead to reduced productivity over time.
In any case, will higher productivity lead to flight of the flamingos? Are female consultants majoring on compassion and connection? Political and managerial demands for higher productivity seem to be at odds with the cry of Hadridge and Pow for more compassion and connection. Within the pages of this redesigned JRSM are arguments over the failings of our redesigned health service, which continues to create a passable impression of an Ostrich or a Lame Duck. The Flight of the Flamingos is a distant dream.
JRSM peer reviewers
Carlos Alvar, University of Geneva, Switzerland; Anne Charlton, University of Manchester, UK; Judith Green, London School of Hygiene and Tropical Medicine, UK; Rodney Hughes, Northern General Hospital, Sheffield, UK; Paramjit Gill, University of Birmingham, UK; Roger Jones, King's College London, UK; Biju Jose, Good Hope Hospital, Sutton Coldfield, UK; Trevor Lambert, Oxford University, UK; Freddy Patel, Greater London Forensic Medical Practice, UK; Ed Piele, University of Warwick, UK; Shonit Punwani, University College Hospital, London, UK; Venkatachalam Raveenthiran, Annamalai University, Tamil Nadu, India; Syed Tariq, Queen Elizabeth Hospital, King's Lynn, UK