Reflection, revelation, judgement and hope.

Four events in recent months have been of significance that they have affected all of us either directly or indirectly. These events like the four horsemen of the Apocalypse bring with them reflection, revelation, judgement and hope. The first of these events is "the Bristol case", a drama of huge proportions which reverberated far and wide and has held the attention of doctors, patients and politicians. If the medical profession is to regain the trust of patients then we must prove that we are serious about self-regulation and we need to embrace wholeheartedly the concept of clinical governance. The Apocalyptic rider on the black horse was holding a pair of scales in his hand. In the aftermath of Bristol we doctors must be prepared to have our work weighed against agreed clinical standards. The GMC has an important role to play, as do the Royal Colleges. Within Northern Ireland we can also look to the Council for Postgraduate Medical Education and to the Medical Faculty at Queen's for leadership and direction. However, we all must play our part in keeping a careful watch on maintaining standards of clinical practice. The second important event was the 50th Anniversary of the NHS. Whilst the birthday celebrations were rather muted we were nonetheless afforded the opportunity to reflect on the success of this very treasured national institution. Many articles have been written over recent months reminding us of the foundation of the health service. The emotions of 1948 are captured for posterity in the words of Aneurin Bevan: "We are doing the most civilised thing in the world-putting the welfare of the sick in front of every consideration". There is no doubt that as a society we still believe that the NHS is "the most civilised thing". The medical profession in recent years has been a very loud advocate of the service, often lambasting successive governments over any perceived threats to the health service. Many young doctors born since 1948 find it almost incredible that just months before the NHS was due to be launched eighty six percent of doctors voted to have nothing to do with it. The lesson for us all is that we need to be ever watchful that a gap does not appear between medical politics and the greater good. The 50th Anniversary has given us an opportunity to reflect on the hardship and deprivation prior to the welfare …