Iona Heath

For regular readers of this blog it may be obvious that I have nothing original to say, but I work in the shadows (or limelight) of others who have extraordinary insight, compassion for their patients, passion for their vocation and exceptional breath and depth of thinking. All are considerably wiser, and not inconsiderably older than I.

In the absence of my own work, -I am very busy with an academic course, a young family and a very busy practice, I offer you some essays by one of the writers who most inspires me; GP and president of the Royal College of General Practitioners, Iona Heath.

More than anyone, she is able to articulate what it is we GPs do. Not only does she write beautifully, but she makes me feel proud of my vocation and inspires me to excell, not for personal gain, reward or status, but in a world of ever-increasing pressures, to be the doctor my patients need.

This quote from Arundathi Roy captures much of what Iona achieves,

“To love. To be loved. To never forget your own insignificance. To never get used to the unspeakable violence and the vulgar disparity of life around you. To seek joy in the saddest places. To pursue beauty to its lair. To never simplify what is complicated or complicate what is simple. To respect strength, never power. Above all, to watch. To try and understand. To never look away. And never, never, to forget.”
Arundhati Roy

There are many short pieces in the British Medical Journal which I strongly recommend, including this interview with her, though they are behind a paywall.

There is a link to her published articles here:

Here are some of her most substantial essays and journal articles which are freely available:

The Mystery of General Practice 1995

‘Uncertain clarity’: contradiction, meaning, and
hope. William Pickles Lecture 1999

‘A fragment of the explanation’: the use and abuse of words 2001

The medical care practitioner: Newspeak and the duping of the public 2004

In Defence of a National Sickness Service 2007

Preventive health care in elderly people needs rethinking 2007

The Concept of Prevention. A Good Idea Gone Astray? 2007

Person centered prevention and health promotion 2010

Measuring Quality in the Therapeutic Relationship. Kings Fund 2010

The Harveian Oration: Divided We Fall 2011

International Futures Forum: Love’s Labours Lost 2012

Kindness in Healthcare: What goes around. Review of Intelligent Kindness. BMJ 2012

Waste and Harm in the treatment of mild hypertension. JAMA 2013

The Art of Doing Nothing. 2013

The ethical implications of excessive prevention. Quaternary prevention, addressing the limits of medical practice  20th WONCA World Conference Prague 2013

Overdiagnosis: when good intentions meet vested interests. An essay by Iona Heath. BMJ October 25th 2013

An Evening with Iona Heath. Blog from Less is More Medicine 2014

The Role of Fear in Overdiagnosis and Overtreatment BMJ 2014

Arm in Arm with Righteousness. PEHM 2015

The Missing Person: the outcome of the rule-based
totalitarianism of too much contemporary healthcare  2017

Papers that share her vision and philosophy:

What evidence do we need for evidence based medicine? Julian Tudor Hart

The End of The Disease Era: Tinetti

Therapeutic Evolution and the Challenge of Rational Medicine NEJM

Why do we always end up here? Medicine’s conceptual cul de sacs and some off-road alternative routes Trisha Greenhalgh Podcast

Resilience and Compassion in the NHS: Lecture with Penny Campling: 2014

Preventing overdiagnosis lecture: 

Less is more: LMC Conference Feb. 2015:

10 responses to “Iona Heath

  1. What an apposite and affectionate celebration of a very special doctor. Thank you for pointing us to these writings.

  2. Patrick Naughton-Doe

    Dr Iona Heath is visiting Hull today to speak to the Hull Medical Society on What Doctors can learn from Larkin (and Marvell). Like you I am inspired by Iona Heath and am looking forward very much to hearing her presentation. I love your quote from Arundhati Roy and hope you would not mind if I used it in my introduction. Many thanks for sharing the links.

  3. My career in NHS finance ended over 20 years ago. I know nothing (yet) other than your blog and Wikipedia, about Iona Heath and even less about Arundhati Roy.

    The quotation instantly brought to mind a man I met around 1970. He was the Medical Superintendant of one of the large mental hospitals around Glasgow. I don’t remember his name or which hospital it was, and because I was taken there by one of my staff, I didn’t even have a clear idea of where it was even when I was there.

    The week before, a colleague from the payroll department who, because of her dress, manners and lifestyle, was regarded as a silly old woman, climbed two filghts of stairs to impress on me, a young accountant very new to the NHS, that I was priviliged to meet this man. She knew that one of the teams I supervised was working there and that I was expected to visit them at some point.

    I was in his presence for as long as it took to eat two or three small sandwiches and two scones with jam at the afternoon tea break. My two colleagues and I sat on the long side of the boardoom table, and the doctor and the chief nurse sat at the short side.

    In that briefest of encounters I recognised that the “silly old woman” was not so silly. (From where I look at things now, she wasn’t so old either)

    Later, I met others like him who had worked in the NHS before 1948, administrators among them. One of them had been working in a charity job before 1948 as a newly qualified accountant geting responsibilities and experience above his pay grade in a world famous hospital. His first NHS tax deduction was greater than the previous month’s charity hospital pay. Mind you the top rate of tax was around 19/6 in the pound then.

    In these days there was no performance related pay. If it had been suggested that he should have it he would have found the suggestion deeply offensive and treated the offer, and the person who made it, with contempt.

  4. Dear writer

    Thank you for this blog. I’m a Dutch GP and I have already read most of the essays you have posted here. I think every GP should read them. Unfortunately I wasn’t able to visit this years Wonca where Iona Heath had a presentation entitled ‘The art of doing nothing’. I would ask everybody: is there anyone who has a pdf or something like that from this lecture?

    Kind regards

    Peter Lucassen

  5. Dear Peter, I have finally tracked down Iona’s presentation, there is a link here:

  6. Thanks for mailing me.It’s so very nice what she writes!

    kind regards

    Peter Lucassen

  7. Peter, that presentation was published in the European Journal of General Practice.

  8. Great job….specially about human vs money vs greed vs NHS……to be continues

  9. susanne stevens

    Where Iona did fail was in her claim to always be speaking on others’ behalf.she could have included their own voices and presence a lot more in many contexts including publications..

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