Officials acting on behalf of Dominic Grieve, the government’s senior law officer, requested the Ministry of Justice to supply reports of Kelly’s post mortem examination, and now have them.

The move comes after a sustained campaign by a group of prominent legal and medical experts calling for a full inquest into the 2003 death of the scientist.

Kelly was a British scientist and expert on biological warfare, employed by the Ministry of Defence, and formerly a United Nations weapons inspector in Iraq. He came to public attention in July 2003 when a discussion he had off the record with a BBC journalist, Andrew Gilligan - about the British government’s dossier on weapons of mass destruction in Iraq - inadvertently caused a major political scandal.

His name was leaked to the press as Gilligan’s source, and he was called to appear on 15 July before the parliamentary foreign affairs select committee, which was investigating the issues Gilligan had reported. Kelly was questioned aggressively, and was found dead two days later in Oxfordshire woodland.

Officials will examine the documents this week before making recommendations to the attorney general, who has the power to order a full inquest.

An inquest was suspended by Lord Falconer, then Lord Chancellor, before the Hutton Inquiry into the circumstances of the scientist’s death. It was not resumed after Hutton’s report in 2004 concluded that Kelly killed himself by cutting an artery in his wrist.

Hutton said: “the principal cause of death was bleeding from incised wounds to his left wrist which Dr Kelly had inflicted on himself with the knife found beside his body”.

Back in January, five doctors who made an application to the Oxford coroner to have the inquest reopened, were told that Hutton made a ruling in 2003 to keep medical reports and photographs closed for 70 years. Hutton responded by saying the documents could be revealed to doctors and that he had made the gagging order to spare Kelly’s family “unnecessary distress”.

Hopes for a new inquest have been raised by the change in government. Dominic Grieve, the attorney general, said in April, when he was shadow justice secretary, that the Tories would consider a new inquest into Kelly’s death.

Section 13 of the 1988 Coroners Act allows the High Court to order a new inquest, or to resume a previous inquest, in special cases.

Grieve also called for a review of the government’s decision not to release related medical records and post-mortem documents. The Hutton Inquiry applied a less stringent test than would have been used in an inquest, where a coroner has to be sure “beyond reasonable doubt” that a person intended to kill themselves.

Norman Baker, the Liberal Democrat MP and a junior minister in the coalition government, supports resumption of the inquest. He resigned from the front bench while in opposition to write a book, The Strange Death of David Kelly, which argued that the scientist’s life had been “deliberately taken by others”.

The campaigners, which include Prof Julian Blon, a professor of intensive care medicine, claim that the official cause of death, haemorrhage from the severed artery, was “extremely unlikely”.

They wrote to The Times last month saying: “Insufficient blood would have been lost to threaten life. Absent a quantitative assessment of the blood lost and of the blood remaining in the great vessels, the conclusion that death occurred as a consequence of haemorrhage is unsafe.”

Speaking to Hospital Dr back in February, one of the campaigners David Halpin, a retired orthopaedic surgeon, accused colleagues of moral cowardice in not getting involved.

Halpin first raised his concerns about Kelly’s death in the Morning Star in December 2003. He then discovered other doctors had also been scrutinising the suicide verdict. One colleague Andrew Rouse, an epidemiologist in Birmingham, had trawled for records of deaths from laceration of the wrist. He had also investigated 271 cases of attempted suicide by slashing the wrist at a US prison and found that only one of the inmates died.

The other doctors in the campaign group include Michael Powers, a QC and former coroner; surgeon Martin Birnstingl; radiologist Stephen Frost and medic Chris Burns-Cox.

They might just be on the verge of a significant victory. As one doctor commented when posting in Hospital Dr’s forum: “People do not die from cuts to the ulnar artery and the amount of distalgesic (his wife’s analgesic) in his system was less than one tablets worth.

“There are other disturbing aspects to this case and sufficient in my view to suspect foul play. If it was a straightforward suicide then why no inquest and why classify the records for 70 years? During the Chilcot Inquiry it would have been very pertinent to know how and why he died. The suggestion is that he was killed to hide an inconvenient truth.

“If he were alive his evidence would have put an end to the lie that Saddam Hussein had any weapons of mass destruction.”

Patients are meant to be operated on within 48 hours, but the annual audit in England, Wales and Northern Ireland showed many waited longer.

The survey of 36,000 patients also raised concerns about access to specialist care, the right drugs and support to prevent future falls.

However, compared to previous years it showed standards were improving.

There are about 76,000 cases every year, costing the NHS about £1.4bn to treat - a figure which is doubled when the associated social care costs are taken into account.

The audit was compiled from the National Hip Fracture Database, a voluntary reporting system which 90% of hospitals feed into.

It found that 80% of patients were given surgery within 48 hours - the recommended time-frame for treatment.

Read more at BBC Health.

Despite all the talk of efficiency and productivity, it’s going to be a tall order - and practically impossible if we want it to stick to its founding principles.

Several recent stories convince me of this. Hard evidence on demand comes in the form of a recent study by the Nuffield Trust which points to a “unsustainable” rise in emergency hospital admissions. There’s been an almost 12% rise in admissions over the last five years, costing the NHS an additional £330 million per year.

The government’s announcement that it’s disbanding NHS Direct, the 24-hour advice line, isn’t going to help. I’m no expert on primary care, but it appeared a useful service that helped take the heat off A&E and GPs.

If you believe the Save NHS Direct Campaign (with it being led by John Prescott, maybe you won’t) then the phone line fields 27,000 calls a day, or 9.5m a year. It’s staffed by 1,400 nurses, provides evidence-based information on its website and scores well on customer satisfaction.

Replacing it with a cheaper service, with fewer health professionals involved, is unlikely to help with demand.

Department of Health figures released this week suggest that GP referrals to secondary care are accelerating once more. Data on outpatient referrals and attendances show the number of GP referrals made from April to June this year increased by 169,000 to 3 million.

Referrals can be clamped down upon temporarily during times of financial crisis, but not when facing inexorable pressure.

It strikes me that there are parallels with global warming (largely because I’ve just ploughed through a weighty tome on the subject to assuage my guilt over reading Stieg Larsson on holiday).

There are loads of things we could do to help with the long-term sustainability of our health system. We should improve our approach to public health, deliver more preventative services, and so on. But, much like reducing our carbon emissions, it’s going to take too long. The NHS is going to be bankrupt long before then.

We have to do something now to deter the ‘time wasters’ from entering the system, and the only way to do this is to put a value on an NHS appointment. We need a simple system of charging for appointments. The usual groups would be exempted from charges and treatment would still be free (I’d even scrap the anomalous prescription charges system).

Jumping back to my rather spurious comparison with global warming, it’s the equivalent of investing in a quick technological fix rather than obsessing about the long game. My personal favourite is to mimic a volcano and pump some sulphur dioxide into the stratosphere to enact some global cooling.

It’s not something you want to do - and there’s always a risk of unintended consequences - but a dramatic approach like this is increasingly necessary, even if it compromises a few principles.

Ok, ok, it might not actually be up on the wall in Paul Dacre’s office, but once you read the Victoria Line all the paper’s animosity towards the medical and social work professions falls into place.

I’m wondering whether I should adapt it for my lowly site (after all, it’s led to Dacre reportedly earning £1.65m a year). I spent several years of my 20s trying to make progress on the Northern Line during rush hour, with little success. On my map, I’d definitely replace Angel, Old Street and Bank with Revalidation, the NHS IT Programme and GP commissioning…

Wendy Chapman cut the lip of Harlequins rugby player Tom Williams to cover up a bogus blood injury and later lied about her role in the event. Dr Chapman was suspended by the GMC in September 2009.

At the hearing in Manchester, the panel ruled that at the time of the events, her fitness to practise “was impaired”.

But it said “looking forward”, Dr Chapman’s fitness to practise was not impaired despite her actions, which it said were not in the best interests of her patient.

Dr Chapman admitted cutting the lip of the player to try to cover up a fake injury and later lying to a European Rugby Cup hearing.

The GMC hearing was told that Dr Chapman had been suffering from a “major depressive disorder” before the incident. She was also awaiting the result of breast cancer tests, the GMC panel heard.

Dr Chapman is currently recovering from breast cancer surgery, which took place in July.

Read more at BBC Health.

Twenty two years ago Dr Steve Bolsin found himself in this position when he took up a post in childrens heart surgery. After many years of struggle he got things changed - but at a huge cost to himself. Now it is time for British medicine to acknowledge the contribution of this unsung hero.

Dr Bolsin was appointed as a consultant anaesthetist in September 1988. Almost immediately he realised that there were problems in Bristol with the conduct of open heart surgery in children. He was particularly concerned about the long duration of surgery and bypass, and the consequent effect on postoperative outcomes. He soon raised this with his professor and his departmental chairman.

The Professor of Anaesthesia in Bristol recalls that Dr Bolsin had: “…expressed his concerns to me about problems in managing small babies following cardiac surgery… He was concerned that the mortality in this group of patients was much higher than he had been accustomed to… I advised him that rather than create waves with little credible evidence, he would be better advised to collect prospective data on babies and children who he anaesthetised for cardiac surgery in Bristol.”

Bolsin carefully audited the process, and continued to draw attention to the problems. In one of his letters he pointed out that the mortality for open-heart surgery in babies was “one of the highest in the country”. He expected that this letter would get a positive response. But instead of a commendation, he received a rebuke, and was sent away to collect more data.

Further data collected over the next three years showed the same patterns. He audited not only the anaesthesia and intensive care, but also at the work of the perfusionists and surgeons. The findings repeatedly demonstrated that there was a high mortality for children having major heart surgery.

At no stage was he told that he was wrong or mistaken in seeking to gather information, and he received assurances that the matter would be looked into. But nothing changed.

Between 1992 and 1995, he became progressively more desperate. He secured the help of senior doctors in other hospitals, the press and the Department of Health. For this he was rebuked, being told that he should not take information to ‘outsiders’ and that he should ‘keep his head down’. As the data he collected become more solid, his working environment became increasingly hostile.

A compounding factor was the uneasy relationship between anaesthetists and surgeons. He found that the surgeons ruled the roost, which made it difficult for any anaesthetist to appear critical of a surgeon.

After many years of adversity his data was finally acted upon. The death rates for children’s heart surgery in Bristol were dramatically reduced as a result of his determined efforts.

He also catalysed the development of a new process in medicine - clinical governance. It’s now used routinely to study and improve medical care across the country. And he was elected as the first national audit coordinator for the Association of Cardiothoracic Anaesthetists of Great Britain.

But here the tale turns sour. His career took a major nose dive, and he found himself unable to work in the UK. He eventually moved to Australia. He’s a forgotten hero of British medicine and, having recently had a quadruple bypass of his own, must wonder whether it was worth it.

The great and the good tell us that we should be impartial and committed, and that Good Medical Practice is based around the concept of integrity. The reality of whistleblowing is that the brave honest and committed doctors who attempt to change things risk professional suicide and spending the rest of their careers in the wilderness. Yet the smiling face of the Professor who Bolsin originally turned to for help is captured forever on an oil painting that hangs in the royal college.

Fortunately the British have a way to recognise and acknowledge the significant contributions that Dr Bolsin made to patient care. The Honours System exists for precisely this purpose. A group of his friends and supporters are now in the process of completing an application for him.

Remedy believes that the awards mechanism of the establishment should be used to bestow honour upon those who truly deserve it. We would wholeheartedly support this application, and invite our supporters to do the same. And there is a Twitter Group to support the campaign.

DH figures on outpatient referrals and attendances show the number of GP referrals made from April to June this year increased by 169,000 to 3 million.

The number of other referrals made has also increased, by 136,000 to 1.7 million - an 8.7% increase against the first quarter of 2009/10.

The figures show that, after an apparently successful clampdown by primary care organisations determined to curb the rise in referrals, GP referrals are beginning to creep up again.

Last month primary care tsar Dr David Colin-Thome said that GP contracts would be re-written to ‘reward them for how much they can benefit from being more efficient providers of care in, say, making less inappropriate use of hospital services.

Read more at Pulse.

Actually, I’m almost hoping that the test produces a (false) positive result, so that I need a colonoscopy. I had to have one a few years ago (false alarm - diverticular disease), and I really enjoyed it. No, don’t get me wrong. It wasn’t the ‘oscopy itself, it was the drugs - pethidine and medazolam…mmmmmmm. Although I was at medical school in London during the swinging sixties, the free love/drugs thing passed me by completely, and the only drug-induced highs I have ever experienced have involved being pissed, and even then, I just tend to get maudlin and start showing people pictures of my kids. The old i/v sedation though, that was something else. I didn’t notice the procedure itself, and if the gastroenterologist had seen something interesting down the scope and had decided to crawl in himself to get a better look, I don’t think I’d have noticed that either. My wife, who drove me home, tells me the stupid grin (mine, that is) lasted for several hours. I can quite understand how that sort of thing could get addictive, he said, stating the bleeding obvious.

Still, it’s good to have a national screening programme that involves men as well as women, I’d begun to think we didn’t count. Is there a ribbon for colon cancer, and if so, what colour is it? Still mustn’t get on to the subject of ribbons just now - that’s a whole rant in itself, and could be a useful filler for one of these blogs if I find myself without a topic.

And this inconsequential contribution has taken so long to complete, that the result of my screening test has, improbably, been posted back to me in less than a week. And it’s negative, which means I’ll have to look elsewhere for mood-altering substances. And of course, now I’m thinking to myself ‘it’s only a screening test though - with a 75% sensitivity, you could still have cancer’. Lucky old patients - they are happy when they get the ‘all clear’. Too much knowledge, and all that.

“Changes are being forced on the NHS with no consultation, no piloting and no evidence,” he wrote in a letter to Lib Dem MPs. “I do not believe that the people who voted for you at the election voted for such a radical break-up plan.”

He warns of a postcode lottery in the NHS where private patients can leapfrog the queue because the Tory health secretary, Andrew Lansley, has dumped Labour’s waiting time targets.

Burnham’s office said it wanted Lib Dems to look again to what was happening to the NHS - and the pitfalls of a policy that was being challenged in the courts.

Read more at The Guardian.

The figures illustrate the challenge the government faces in trying to tackle the problem of obesity. In 2008-09, the NHS carried out 4,246 weight loss operations, including stomach stapling and fitting gastric bands, compared with 480 procedures in 2003-04, according to the NHS Information Centre.

Of the operations performed in 2008-09, 42 involved full or partial removal of the stomach; 1,378 involved fitting a gastric band to make the stomach smaller; 504 involved stomach stapling; 2,210 involved a gastric bypass; and 124 inserting a “bubble” in the stomach to fill it up. Patients may have undergone more than one procedure in the same operation. The upward trend in the data suggests the figures for 2010 could be higher.

Read more at The Guardian.