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Silly season frustrations


Silly season frustrations

We are left with influential managers who are marinated in their tasks and entrenched in their organisations

Independent proprietor Sid Dajani finds a little light reading keeps him calm in a crazy environment

It is the season of sunburn, bites, stings, hayfever, burnt sausages and badly cooked chicken. Or – as we call it in the trade – Imodium Season! Soon the flu season will be upon us, but it always feels like the silly season because you just cannot prepare for the random or silly things that people do.

A lady brought in a urine sample for a pregnancy test in a sealed plastic takeaway box wanting me to verify what she had tested at home. It was half full! When we used to do pregnancy tests on a regular basis I had urine coming out of my ears (metaphorically speaking) and literally coming out of yoghurt pots, cups and milk bottles, all usually covered in a bit
of clingfilm.

Once we even had a stool sample posted through the letter box with a note asking us to take it to the GP. That ruined everyone’s lunch for a week!

As we move from the Imodium Season to flu, I am weary. I have been ill and was recently back in A&E following an altercation with a step-ladder that didn’t want to be put back in its place. I don’t know who won in the end because, although the ladder was put back, it exposed bone and I needed seven stitches. I didn’t get home until 5 am on the morning of my birthday.

Dream holidays

Normally I’d have had a holiday by now, but not this year. Some dream of going to places where they can experience bougainvillea petals drifting across the azure water of the pool, lying in the shade, with thoughts of a light lunch on their mind. Others dream of going to places that evoke emotional and cultural awakenings, or to breathtaking places where they can watch the sun setting over a loved one.

And quite right too, if you can afford it. But I love reading, which apart from being the definitive mechanism for self-development, is a form of escapism. Each book is a record of where I’ve been, opening up whole new worlds of opportunities and answers.

And as I get older, reading adds a whole new dimension; it is a fragment of timelessness to distract me from the inevitability of my own mortal ruin! As a teenager I used to love reading, surrounded by nature, among towering bookshelves of incredible writers, or even in the comfort of my bed or a comfortable armchair. In fact, anywhere I could find space and solitude, which would sometimes be a lunchbreak in a basement of a community pharmacy where I was locuming, or at the Riverside Café when I used to work at St Thomas’ Hospital.

Even now, despite having little or no spare time, I am still fond of reading. It keeps me sane because it is the ultimate exploration of ideas, places and people you’ve never met but might exist. Reading makes my world bigger. Unfortunately, the only reading I do these days is usually the sort where the pages have notes in the margin, coffee cup rings all over them and various ‘FFS’s dotted here and there!

Wrestling and Elvis

So no escapism for me this summer, but I did read a classy report, written by people who know their stuff and probably shop in Waitrose. It fully explains why GPs alone cannot save the National Health Service, why politicians and health are as unlikely a match as wrestling and Elvis, and why we are in this mess.

It’s all thanks to health bureaucrats who do bad jobs but manage to cling on through the distracting, frustrating and expensive reorganisations of the NHS. They represent failure surviving under a different banner and at a different desk. Unfortunately, new badges do not translate to new ways of thinking, because structural changes don’t lead to and are not the same as cultural ones. And so we are left with influential managers who are marinated in their tasks and entrenched in their organisations.

The report slates the reforms and clinical commissioning groups, predicting that Number 10 will manage to find an apparatchik with a strong enough foot to kick them all into the long grass within a few years.

Quite right too, because changing who does the commissioning is not ‘modernising’; it is changing who does the commissioning. It won’t make old people young, fat people thin, or blue collar workers present sinister symptoms earlier.

There is no evidence that CCG commissioning has improved care, created better value for money, or improved innovation. And who would deny the evidence; it has cost an absolute fortune, diverted attention and made the wrong people wealthy.


CCGs run by GPs have hogged the cash and local commissioning has been so poor that you would think they were really ‘decommissioning groups’! They’ve expensively struggled and failed to ‘commission’ anything beyond PCTs’ cheaper failed efforts. CCGs are proving to be pointless, right up there with slugs and black pudding.

The Lansley legacy is a tragedy. Politicians would do well to remember that we are all custodians of this great public service and we do it no favours by making it unworkable. The reason why this report was an eye opener was because it was written by a think tank of GPs.

You don’t need a unique 360-degree vision system of complex mathematics or probability theories to know exactly what they are saying.

The door to throw CCGs out is opening and to see this in print was as emotional for me as, I guess, others might find watching the sun setting over Anne Hathaway’s’ body in Santorini.

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