The Witch Doctor has a few unread medical books on her shelves that are not text-books. The other day she found one that is now out of print. She decided she will now read it slowly and in so doing try to imagine what the old GP would think of today’s changes in the healthcare system. If still alive he would be 112 by now.
The book is called “Gorbals Doctor” This was the name given to Dr George Gladstone Robertson who spent his whole life working in what was considered the toughest part of Glasgow. He saw The Gorbals slowly change from an area of large flats inhabited by “the well to do” into one of the filthiest slums in Europe, the eruption of gang-land, and finally the slum clearances – the demolition of buildings, friends and neighbours as families were moved into utilitarian housing schemes built on farm land some miles away or into local high flats.
He was still working full time into his 70s and at that age drove a white MGBGT around the toughest streets in Glasgow. He never locked his small but conspicuous car when he did his visits. It wasn’t necessary. Everyone knew it was “The Doctor’s car.” No one would enter it or steal it. A kind of loyalty existed among the Gorbals folk. Perhaps he was considered in this environment to be some kind of demi-god.
So WD and My Black Cat might be quiet for a while as we savour his memories. On the other hand if we find something in the book that takes our fancy, we might share it with you.
If we can be bothered……
In the meantime, we will have in mind the post below that we first published nearly five years ago as we compare the life of the “Gorbals Doctor” to what we see developing today.
THE WHEELIE-BIN DOCTORS
Doing a dentist:
You know, My Black Cat, The Witch Doctor remembers well the time most dentists came out of the NHS. It was a scenario carefully orchestrated by the government, and The Witch Doctor is of the opinion that it all went according to “The Big Government Plan” at the time.
Toothache, so what!
(Have you ever had toothache?)
Fillings, so what!
Orthodontics, so what!
DOING A DENTIST
“Doing a Dentist” would not lead to increased patient mortality.
Or if it did, it would not be easily apparent to the punters (patients and clients) that the lack of dental facilities was to blame.
Now we see huge queues when a new dentist, who is prepared to do NHS work, opens.
And dentists are flown in from Poland on occasion to “fill the gap.”
Mark you, some say the dentists did OK out of it, because the marketplace dictated a demand for dentists.
Beautiful teeth are a cosmetic blessing.
(And toothache is a terrible thing).
Anyway, that’s all in the past, the medical establishment didn’t take too much interest then. Doctors were different. Patients die without doctors. This could never happen to GP’s.
Another huge tidal wave of “The Big Government Plan” is about to engulf the GPs.
More difficult for the government this time, though. This is not about toothache, fillings, and orthodontics. Without doctors, patients will die and this will be apparent to all. Big court cases. So there has to be a fallback position.
The fallback position is an excellent one.
THE FALL-BACK POSITION
It will boost the economy – our economy, and the US economy.
So that makes it altruistic.
The punters’ (patients and clients) taxes will be diverted into multi-national companies who will provide health care.
Free health care – now, but not always.
The multi-national healthcare companies will want a ROTUND clientele but a LEAN workforce.
That’s why we’re all hearing about Toyota-style LEAN-NESS.
Better health care.
Better health care – because the patients will be seen in interior designed surroundings with fresh flowers, well nourished pot plants, and music in the toilets. Local artists will be encouraged to display their original paintings on the walls. No tacky prints here!
Staff will all have excellent communication skills. They will smile a stage smile and will never forget to remind you to “have a nice day” – or the up-market London equivalent, or the up-market Yorkshire equivalent, or the up-market Liverpool equivalent. Staff will not chew gum. This is because they are following the “smile” and the “nice day” protocol. This protocol does not allow chewing gum. They hold certificates for these protocols. The certificates will be proudly and elegantly framed and hung on the wall. These “Competent Clinical Decision Makers”*** who are not doctors will have many certificates displayed on the wall of their rooms: for they will have sat lots of little tests for lots of little skills. And passed them all. The degree in handwashing. The certificate of “niceness.” The “empathy” diploma. The punters (patients and clients) will be impressed.
BETTER, LOVING, HEALTH CARE
The more gregarious doctors might have one or two certificates on the walls. The little unimpressive one that says “MB ChB” will go un-noticed by the punters (patients and clients). The more reticent doctors will keep their unimpressive certificates somewhere in a suitcase in the attic. This is just as well, because soon there will be no wall available for doctors’ certificates because there will be no doctor’s rooms. Doctors will become the “Wheelie-Bins” of the new NHS. Wheeled into the elegant rooms of “The Competent Clinical Decision Makers” when the diagnosis and treatment is forming the shape of a pear. The doctors will do salaried part time work on a sessional basis. There will be many young women doctors working two, three or four sessions per week. With some exceptions, these women doctors will be more malleable than the full-time men. They will be wheeled about from branch to branch of the big multi-nationals to cover sick leave and maternity leave. These “Wheelie-Bin Doctors” will not know their patients from Adam. But the “punters” (clients) won’t care. Some other “punters” (patients) will.
A GP’S OFFICE IN THE NEW GLOBAL NHS
That’s the way it will be.
Won’t it, My Black Cat?
“The Competent Clinical Decision Maker” is coming of age.
***N.B. The term “The Competent Clinical Decision Maker” was first noticed by The Witch Doctor in October 2007.
You think it was a term introduced by the government?
By the National Practitioners?
By the nurses?
By the pharmacists?
By Skills for Health”
It was introduced by The Royal College of Physicians in London in October 2007.
Yes, the term “Competent Clinical Decision Maker” was introduced by doctors – senior doctors, although the term seems to originate from Iran.
Introduced by senior physicians working under the aegis of The Royal College of Physicians in London, at a time the country was on the brink of massive unemployment of junior doctors.
Now there’s a thing to chew over.
Eh, My Black Cat?
a red apple ……………………