· Another flip of the calendar, another awareness week. For a long time I was under the impression that "awareness" was a good thing: campaigns, ribbons, stickers, leaflets and pledges would help stop cancer, heart disease, strokes and even restless legs. But I've changed my mind. Information is power, but it hardly helps if the information you receive is an emotive agenda dictated by which celebrities will offer endorsement. Not to mention the pharmaceutical industry, which funds multiple awareness campaigns that may seem, at first glance, to be nothing to do with the medication that is usually suggested.

All this means bias, and the very real danger that the less glamorous conditions - mental illness, care of our elderly, diabetes, kidney failure, and especially illnesses without a "new drug" solution - will get less attention for funding and services. And there is so much uncertainty in many areas of "awareness" (cancer screening in particular) that truly balanced information is often skimped on.

Sadly, there is only so much we can actually prevent - for example, teaching women breast self-examination doesn't prevent deaths from breast cancer - and, most of the time, such campaigns bypass those at highest risk and preach instead to the worried well. A study in the American Journal of Medicine examined the psychological state of men who had a blood test for prostate cancer (PSA) with a high reading, but subsequently had a biopsy of the prostate that showed no evidence of cancer. The researchers found that men with the high false-positive PSA test worried and thought more about prostate cancer than men whose initial blood test was normal. We should never assume that what may be a sincere, well-meant campaign cannot be, for some people, unhelpful, or even damaging.

· Electronic medical records for all UK patients are in the final stages of planning. There is much to be said for medical notes that can be shared between the team caring for you. But electronic medical records will not just be open to your necessary healthcare staff. Pilot studies have shown instances where the Department of Work and Pensions has accessed medical records in respect of benefit payments. The conflicts become enormous - would you risk telling your doctor some thing if you were worried it might end up outside the surgery? Would your doctor record something he or she thought might be used to your detriment elsewhere?

It seems we will not be given the chance to opt out of having our medical records stored electronically. There is the real possibility that electronic records, far from improving healthcare, will instead erode doctor-patient trust. Confidentiality is the keystone of medical care, and denigrating it is to everyone's disadvantage.

· The scope for who can wield the scalpel is to be widened. A consultative document has been launched for a national training framework. Essentially, the surgeon of the future might not be medically qualified; certain operations, such as hernia repairs, may be done by nurses, operating theatre assistants or school-leavers on a health foundation degree programme. Is this modernisation or cost-cutting? I don't think waiting lists will be reduced simply with a few more people operating. Most operations aren't cancelled due to a lack of surgeons, but a lack of theatre space or intensive-care beds.

This isn't about what nurses can or can't do; many nurses retrain as doctors. But even before the new developments, there were concerns about guideline-driven medicine. Dr Craig Gannon, a consultant in palliative care, describes in this week's BMJ a patient who died in the care of multiple specialist teams: "Worryingly, it was the system - increasingly engineered to medical technicians rather than to professionals - that seemed to be responsible."

· Jamie Oliver's early cookbooks, before he had children of his own, contained many admonishments to parents who failed to cook fresh food for their kids. At the time, in exhausted postnatal purgatory, this irritated the hell out of me. I have since swallowed my pride, and now think Jamie Oliver is a hero. However, let's not pretend that we can blame schools for all the vile, fatty, sugary food children eat: it's most likely to be served up by parents. This week, in a renewed effort, I have banned nuggety mush from the freezer and forced sweetcorn, peas and carrots on to the menu. It's a start. It's also mutiny.

· Margaret McCartney is a GP based in Glasgow.