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This paper briefly outlines health advisor L.W. Harrison's contribution to venereology or genitourinary (GU) medicine, and shows how his principles of good practice fulfil many of the principles of clinical governance. The paper then outlines some general principles of clinical governance and indicate how they relate to GU medicine. Harrison set up the specialty on a firm foundation of clinical excellence that fulfils many of the latest requirements. He would have been thrilled to see how the specialty has broadened and would have applauded the drive for excellence. However, he might have been concerned over the literature on clinical governance, reminding that the pursuit is excellence of clinical care for the patient, and that clinical governance must not become an end in itself.

The emergence several years ago of SARS, with its high rate of infection and death among healthcare workers, resurrected a recurring ethical question: do health professionals have a duty to provide care to patients with deadly infectious diseases, even at some substantial risk to themselves and their families? The conventional answer, repeated on the heels of the SARS epidemic, is that they do. In this paper, I argue that the arguments in support of such a duty are wanting in significant respects, and that the language of duty is simply not adequate to an understanding of all the moral dimensions of professional responses to the care of risky patients. Instead, we should speak the language of virtues and ideals if we want to do justice to the complexity of such harrowing circumstances. [ABSTRACT FROM AUTHOR]

Objectives: To examine various models of integrated and/or one stop shop (OSS) sexual health services (including general practice, mainstream specialist services, and designated young people's services) and explore their relative strengths and weaknesses. Methods: Literature review and interviews with key informants involved in developing the National Strategy for Sexual Health and HIV (n = 11). Results: The paper focuses on five broad perspectives (logistics, public health, users, staff, and cost). Contraceptive and genitourinary medicine issues are closely related. However, there is no agreement about what is meant by having ‘integrated’ services, about which services should be integrated, or where integration should happen. There are concerns that OSSs will result in over-centralisation, to the disadvantage of stand alone and satellite services. OSS models are potentially more user focused, but the stigma that surrounds sexual health services may create an access barrier. From staff perspectives, the advantages are greater career opportunities and increased responsibility, while the disadvantages are concern that OSSs will result in loss of expertise and professional status. Cost effectiveness data are contradictory. Conclusion: Although there is a policy commitment to look at how integrated services can be better developed, more evidence is required on the impact and appropriateness of this approach. [ABSTRACT FROM AUTHOR]

Editors of "Sexually Transmitted Infections" wish to bring to the attention of readers of the journal the significant overlap between articles entitled "Who has Chlamydia? The prevalence of genital tract Chlamydia trachomatis within Portsmouth and South East Hampshire, UK" which was previously published in the Journal of Family Planning and Reproductive Health Care. The paper published in Sexually Transmitted infections was written and submitted for publication according to a publication strategy agreed by the Department of Health's Steering Committee for the national chlamydia screening pilot, that the first publications from the pilot should be based on a combined analysis of results from the two sites taking part in the pilot.