Farewell Dr Finlay


Glasgow GP, columnist in the British Medical Journal, and regular contributor to 'Inside Health', Dr Margaret McCartney, presented this 2-part series on the history of general practice in the UK since the middle of the 18th century.  First broadcast July 2016, repeated January 2017, both Radio 4.

McCartney interviewing Edwards

With the help of leading medical historians such as Professor Anne Digby, Dr Martin Edwards and Dr Graham Smith, along with a wide range of GPs, including the legendary writer and historian-GP, Julian Tudor Hart, these programmes set out the extraordinary story of our family doctors, from the somewhat brutal days of the surgeon-apothecaries this history begins.  Then on through the 19th century, the landmark Medical Act of 1858 that set up the General Medical Council and much more besides.  Into the 20th century with the 1911 National Insurance Act, which produced 'panel doctors' to look after employed men (and some employed women) - but not spouses, children or the self-employed.

Rounding up of course, and this is what part 2 is all about, with the NHS, the "Family Doctors' Charter" of 1966, the free-market "fundholding" practices from 1989, and the slow retreat from being on-call 24/7.  Up to the present day, with many GP training courses vacant, practice places unfilled for long period, some practices closing, combined with ever-increasing workload, regulation and administration.

Picked by the Daily Telegraph, Times, Daily Mail, Sunday Telegraph, Observer, Mail on Sunday, Financial Times ... including "this fine two-part documentary ... from 18th century surgeon-apothecaries to today's GPs is a fascinating route" (Gillian Reynolds) 

BBC programme pages: episode 1episode 2
(available to listen online as part of the BBC's long-term archive)

Too Much Medicine? The problem of overtreatment

Glasgow GP, columnist in the British Medical Journal, and regular contributor to 'Inside Health', Dr Margaret McCartney, investigates the controversy of medicine's search for traces of disease in people who would otherwise never know about them, or suffer any ill effects.

There's growing world-wide concern about the extent to which screening programmes and advanced diagnostic tools are finding signs of serious diseases, particularly cancer, in people who are outwardly healthy. For example, in South Korea, a mass screening programme for thyroid cancer has detected 15 times more cases than before it started - yet there's been no improvement in death rates from the disease.

The fundamental problem is that the harder doctors look for disease in people who are apparently well, the more they will find. Yet most of it will never matter to those people.

As a result, there is a movement towards Slow Medicine - echoing Italy's Slow Food campaign - that puts more emphasis on shared decision-making between doctor and patient, not always prescribing every possible test and treatment, and keeping people "in the kingdom of the well" as long as possible, rather than moving them prematurely into "the kingdom of the sick".

Produced by Mike Hally

A Square Dog Radio production for BBC Radio 4.

BBC programme page
(available to listen online after tx)