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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 September 8; 335(7618): 465.
PMCID: PMC1971161
Unholy Trinity

Stance is worst type of spin

Roger H Jones, Wolfson professor of general practice

I am not alone in my surprise at seeing Delamothe join Dearlove on the moral low ground to support his position on the public and professional impacts of Bristol, Alder Hey, and Shipman.1 Above the shuffling of closing medical ranks I can catch the words of Hampton's 1983 editorial on the end of clinical freedom, “at best a cloak for ignorance, at worst an excuse for quackery.”2

Dearlove demands evidence, as if an opiate. Lack of evidence of effect is not the same as evidence of lack of effect. The Department of Health's MORI polls, whose responses are likely to be driven largely by recent direct medical contact, show that 14-17% of patients have reservations or negative opinions about the competence of doctors.3 4 5 In the British social attitudes surveys 16% of respondents expressed dissatisfaction with general practice and more with the NHS generally ( After Alder Hey, Cancer UK reported a sharp fall in donations of tissue to the national tumour bank for children's cancer, and 3000 families joined in a legal action against the NHS.

To suggest that the political and professional responses to the unholy trinity were a conspiracy between the government and the media is as bizarre as failing to recognise that the actions of individual doctors and hospitals were not isolated events but the alarm symptoms of deeper problems. To caricature all this as an anti-medical machination of the Blair government seems to me the worst kind of medical spin.


Competing interests: None declared.


1. Delamothe T. Why this unholy trinity? Editor's choice. BMJ 2007;335 doi: 10.1136/bmj.39308.477870.BD
2. Hampton JR. The end of clinical freedom. BMJ 1983;287;1237-8.
3. Department of Health. National surveys of NHS patients: coronary heart disease London: DH, 2001
4. Department of Health. National surveys of NHS patients: general practice 2002 London: DH, 2003
5. Department of Health. National survey of NHS patients: cancer: analysis of themes London: DH, 2004

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