Tuesday, November 27, 2012
Tuesday, October 23, 2012
Friday, August 10, 2012
Friday, June 22, 2012
Friday, June 01, 2012
Tel: 020 7219 3475
And remember to sign off “LOL”
I'm told he likes it.
Monday, May 28, 2012
Friday, May 18, 2012
Wednesday, May 02, 2012
Friday, April 27, 2012
Wednesday, April 18, 2012
Two weeks ago, in mid-afternoon surgery, there was a soft “plink” noise. Only a quiet noise, but such a noise as comes laden with evil portent. Accompanying the “plink” was a flash of the screen, followed by an evanescent appearance of the fabled BSOD* then nothing. Like a heavyweight boxer smacked on the chin by Ali in his pomp, my computer folded at the knees, collapsed to the canvas and tiny cartoon bluebirds started flitting around its brow to the accompaniment of a tweety whistle.
The gremlins had struck with perfect timing, late on the Wednesday before the Easter weekend. So Maundy Thursday morning we called IT. They promised and engineer on next working day (i.e. Tuesday). No big problem as one of our learners was off on hols and her broom cupboard --- er *room* (ahem) was free to consult in. **
After a tranquil and relaxing Easter (yeah right… but that’s another whole set of stories involving fire and sacrifice and tedious little distractions of a similar sort, not for here and now) your humble interlocutor was out of surgery on Tuesday morning touring the Nursing Homes of the district—part of a new initiative to enhance our care of the elderly-- and so fully expected to be back after lunch to find a shiny new terminal humming away right as nine-pence.
No such luck!
Happily we were a nurse down so had a treatment room spare, with a computer in, so 3 days 3 rooms and on with the motley. Except none of the punters could get used to the idea of me consulting in the nurses room and all and sundry developed a compelling need to rummage in the treatment room cupboards for this dressing or that blood tube as I was trying to work. Still we got through. But by close of play still no sign of IT.
Wednesday and Dr Neighbour was out all morning—day 4 room 4 and by now it wasn’t just the punters that didn’t know where they were going. All my diagnostic kit was liberally distributed through the other three rooms, all of which were now in occupation, so whenever I needed to check an ear, dip a urine or test a BP I was off wandering the corridors like a lost soul looking for my kit. Oh and Wednesday we had a student in for tuition with yours truly. The poor thing didn’t know what on earth was going on, but gamely took to entertaining the punters whilst I roamed chuntering through the building questing for this or that.
IT phoned late on Wednesday and announced they would definitely be in on Thursday. Probably.
Thursday we had a problem. Everybody was back in and consulting, so I had a room (my own) with no computer, and there was a computer in the office space behind reception with no privacy. Solution, print out contact sheets for the whole surgery (recent history, significant problem lists, current meds and any up to date bloods) and consult without the “one eyed monster” writing scripts by hand and updating the computer record afterwards. Simples!***
So sure enough two patients in, IT guy arrives to install a new box and take the old one away to be sealed in carbonite and buried in a vault on the Death Star. Brilliant news, except that he needed an hour and a half to twiddle knobs and adjust dials to get the thing working properly. And it’s a one time now or never offer ‘cos he’s got to be elsewhere working for a godlike NHS manager by 13.00 and he’s off to a stag do in Amsterdam after that (you’re thinking TMI right? So was I). So send all the punters home or try to consult in the car park? As I ask the question of our chief receptionist we both look to the vacant practice manager’s office for inspiration. P.M. off for the week getting drowned in the balmy post Easter rains so no help forthcoming from that quarter.
Now I know you’re all already ahead of me here. Office, vacant, and with computer linked to clinical system. There followed what the younger generation would call a face-palm moment.
Day 5 room 5 and by lunch surgery sorted and back, at last to normality. I’m back in my Tardis and all’s right with the multiverse. Excepting the trivial matter of a loss of data slowly gleaned over ten or so years of consulting and only partially and fitfully backed up. And the abiding impression of a few dozen punters and a final year student of my Alma Mater that I’m a bumbling fool who suffers with terminal “olecrano-gluteal dysgnosia”****.
*Blue Screen Of Death
** Yes the Ambridge surgery treats its learners rather like Hogwarts does. Only without the pointy hats and wands and such.
*** In joke in Blighty about a talking meerkat. In all honesty if you need to ask you're better off not knowing, trust me. (Though You Tube will probably oblige, but you’ll really wish you hadn’t bothered. Honest.)
**** EVCHN for first correct translation. (There's a tiny clue in the title)
Friday, March 09, 2012
Ray’s been back in a couple of times recently. When he arrives the front of house team find him and his dopey black lab a quiet seat out on the maelstrom that is our waiting room, and instead of the usual summoning by bells I actually get up and prowl the corridors to fetch them. Only the time before last there he was on his own.
The last time that happened it was because “Rockstar-dog” his first and dare I say prettier guide dog had succumbed to a coronary at the relatively spry age of ten. Since then he’s had “Dopey-dog”, who has been a faithful, if far more docile companion. So, with grim inevitability, I plant a size nine boot firmly in mouth by enquiring “What, no Rockstar-dog today?” Ray is of course far too much the gentleman to pull me up on my alarming faux pas, but gently says “No, Dopey-dog is out with my neighbour for a run...”
Our consultation runs its course, he’s actually looking better now than last summer when he was experiencing problems with his meds, and as we finish and I’m walking him back to the pharmacy, we return to the subject of the absent Dopey. Apparently the neighbour purloins him now and again to prowl the perimeter of the local golf course, seeking out strays. Stray golf balls that is. It turns out the neighbour is a devotee of the “good walk spoiled”.
Happily the quote stays firmly in my head, as Ray inquires if I play myself. I have to sheepishly admit I do not. I know it’s something of a cardinal sin for a chap of my tender years and noble profession not to play, but I never really saw the point. At my admission Rays face lights up in recollection—“You really should you know, it’s a great game. I used to love it, back before the arthritis got me.”
Now Ray is almost to the day ten years my senior, and the arthritis well and truly got him a good three and a tad decades ago. Anything that sparks such an evidently joyful reaction on reminiscence can’t be all bad, can it? So now I’m beginning to wonder if I’m missing out on something. Not that I’m sure I’ve got the time for a new pursuit just now, but that’s another story.
And yes, Dopey-dog was back next visit, and still in need of guiding, by me, to my room, the room he’s been coming to four or five times a year for most of his adult life while he’s been “guiding” Ray. But it seems the both of them know their way around a golf course better than I’m ever likely to.
Friday, February 10, 2012
I can’t quite believe I’ve done this, but after a small discussion piece courtesy of Aunty this morning (Radio 4 Today programme to be exact—where else?) I’ve just toddled over to the dark side for a peek at “Conservative Home”. It’s a scary place for a dyed in the wool pinko liberal like myself, but Tim (the proprietor of same—apparently that’s how his punters like to name him) has woken up far too late in the game, to the unpopularity of the Health and Social Care Bill. Well done Timbo. Trouble is you’re a couple of years late and a tad more than a dollar short (roughly £20 Billion in modern nomenclature).
The reality is, whether Dave ditches Nutter Lansley (the Fred Dibnah of NHS restructuring) or no, the damage is already done. The changes our esteemed Health Secretary wanted made have been enacted by fiat, un-trialled and unchallenged and there’s no turning the clock back now, Bill or no Bill the NHS must restructure because he’s already blown to tiny pieces the bodies that were running the fractured health economies that made up the hopelessly balkanized soi-disant “National” Health Service. With PCTs de facto abolished and Commissioning Groups champing at the bit to take over (but still in our locale hopelessly ill equipped and un-resourced), Dave and the soaraway success that is our coalition can fiddle all they like. Rome is well and truly ablaze and we can only await the Phoenix that will arise from her ashes.
Tim’s article and the opinions of his various commenters just go to show how utterly our political class fails to grasp “health” as an issue. They can’t resist tinkering and faffing. As I’ve argued before it would be impossible for them. It’s not their fault, and it’s not particularly different under this administration if I’m honest, except in outcome. Lansley has been more radical that some, less than others in his stated intent, but worryingly, he has been let loose to run amok BEFORE fully framing the legislation and establishing the structures that would allow his reforms to take shape. The last time this happened, in 1997, it took us a while to sort, but thanks to the dedication and professionalism of countless much derided NHS managers, and the care and devotion of all the NHS professions, it got sorted.
My worry is that we’re not now the service we were then, and that the dedication and devotion has been severely eroded by over a decade of being on the sharp end of loony initiatives and make-work restructuring, plus struggling to hit unattainable targets, like performing seals honking air horns for fish. And this erosion is far from the fault this administration alone. Indeed though the seeds for our present difficulties were sown by dear Margaret Hilda and her barmy army, they were seized on wholeheartedly by Tone and Gordon and driven further and harder under them than I suspect any right of centre government would have dared.
So if this is all sounding rather like a counsel of despair, you’re probably right to see it as such. It is far from clear what our battered health services will look like when and if the dust settles. Locally our own health economists are looking at a “once in a lifetime opportunity” to reshape services for the future, but I fear even before their plans have been drafted we’ll be moving on to the next initiative— and scrapping the bill will make very little difference one way or the other. Sadly health in real life isn’t like health in the popular imagination—fuelled as that is by dramas that wrap up a complex case in sixty minutes (forty five on independent channels to allow space for adverts for things almost calculated to make you ill). And politicians, as again I think I’ve said before, are taught to think in terms of balance sheets and changes to be delivered in their entirety within eighteen months or at least ahead of the next reshuffle. So Tim, if you’re listening—and I can’t see any reason you would be-- say what you like about the bill and its prospects for Dave’s re-election chances, but please, please spare a thought for the poor bastards on the receiving end* of your masters' extravagant insanities, and try to persuade them to think in terms of generations and not reshuffles.
* Oh and by the way that’s all of us—assuming you’re ever unfortunate to suffer a long term ailment that the private sector won’t insure—like diabetes, arthritis, heart disease, chronic lung disease, any occupational ailment..... well pretty much anything except a boob job** if I’m honest. Oh and especially NHS managers—those we have left.
** Oh and probably boob jobs too-- at least if they were done on the cheap.