The best laid plans?

The Icelandic island volcano pushed the UK parliamentary elections from most front pages this week, but not from the BMJ’s cover. “How I long for a politician brave enough to say the NHS is unsafe in our hands…it begs for a Martin Luther to nail his 95 theses to the door.” So says Nigel Hawkes in our round up of views on the election’s health issues (doi:10.1136/bmj.c2095). Among many contributors, Ann McPherson wants government to stop the endless NHS reorganisations, to build on valuable experience, and to cherish general practice; Angela Coulter has her vote ready for whichever party produces a credible plan for empowering people to take more control over their own health; and Ian Gilmore is frustrated that policies seem “mostly at the level of principles while across the country concerns are surfacing of panicked cuts that belie the politicians’ reassuring words.” If you’ve not yet had time to pick over the health plans from the manifestos of the three main UK parties, Nigel Hawkes has done it for you (doi:10.1136/bmj.c2058).

It’s too soon to know all the effects of the volcanic eruption on health and health services. Zosia Kmietowicz reports on one immediate and very serious consequence of closing European airspace: the failure of stem cell transplants from bone marrow donors abroad to reach patients in the UK (doi:10.1136/bmj.c2185). A far less important casualty has been the international medical meeting, and webcasting has come to the rescue for some. Desmond O’Neill found that this technology brought unexpected informality to a Dublin conference on music and neuroscience, including the rare chance to see and hear one stranded guest—a celebrated violinist—performing in his own home (doi:10.1136/bmj.c2180). Tessa Richards was meant to chair a debate at the Geneva Health Forum about responses to the H1N1 pandemic, but had to watch its much depleted version online instead (http://blogs.bmj.com/bmj). And, as we went to press, the International Forum on Quality and Safety in Healthcare organised by the Institute for Healthcare Improvement and BMJ Group was set to proceed in Nice, backed up by live video streaming and other web services (http://internationalforum.bmj.com/2010-forum). Will greater use of videoconferencing emerge from the ash cloud’s silver lining?

In their clinical review Sebastian Kalwij and colleagues point out that Chlamydia trachomatis infection is the world’s most commonly diagnosed bacterial sexually transmitted disease, is detectable by highly sensitive and specific tests, and is easily treated (doi:10.1136/bmj.c1915). Nonetheless, as editorialist Jessica Sheringham explains, lack of evidence on the related burden of serious disease continues to hamper the development of effective mass screening (doi:10.1136/bmj.c1698). The Prevention of Pelvic Infection (POPI) trial in more than 2500 female students in London might have added crucial evidence. It asked the important question:“do testing and treating sexually active women for chlamydia infection reduce the incidence of pelvic inflammatory disease in the subsequent year?” But despite the best efforts of Pippa Oakeshott and colleagues, it yielded no definitive answer (doi:10.1136/bmj.c1642).