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Phil watches glumly as the builders move in opposite to fling up a nursing home

Last year, the builders moved in on the vacant plot of land just opposite our surgery. One morning we came to work and there was a big wooden placard hammered into the virgin turf, bearing the legend 'QCH'.

According to the sign, this legend stands for 'Quality Care Homes'. But from a GP's point of view, it means something else entirely.

My partner thinks it signifies 'Quavery Codgers Here', while I think it means 'Quantity of Crinkly Heartsinks'.

We stood glumly in our doorway, watching the contractors fling the building up in about a fortnight. In seemingly no time at all, the roof was on and the special piss-proof carpets were being carried in.

From our office window, we cursed under our breath as we saw the horrible generic wall art arriving in a van.

Portraits of Vera Lynn. Pictures of loveable street urchins with dirty faces and huge boots. Puppies. Prints of black-faced miners with ponies. The Queen Mother, looking ethereal.

I felt sick. I might be looking at this rubbish, on a daily basis, until I


Then came the fateful day. A series of taxis, ambulances, and in one or two cases, forklift trucks arrived, delivering the hapless new residents to their cells. Frantically we redrew our practice boundary to include an area not more than nine inches from the surgery

walls, but it made no difference.

The next day, a gasping postman limped into the surgery with a huge sheaf of letters from the PCT.

Each letter, in essence, said the same thing. 'This crumbly, senile old git has been allocated to your list. He/she is your problem now, pal. Enjoy.'

Within hours the new manager was at the front desk, asking on which days of the week we would be doing our rounds. Not on which day, but on which days.

It was too awful to contemplate, and our senior partner snapped into action. 'This is a forward-thinking modern practice!' he barked at her, 'and doing home visits, let alone regular rounds, is an outdated relic of the 20th century. We shall not be doing visits to your nursing home!'

It was a tense moment. They stood eyeball to eyeball, and mercifully the nursing home manager cracked first. 'But these are vulnerable old people,' she complained, 'and they are not very mobile. How will you examine them?'

'This surgery has very wide front doors,' explained our senior partner, 'and the road between us is not all that busy. Your beds have got wheels on them. A member of your staff could easily run them over to our waiting room.'

She left, looking stunned, while we high-fived one another gleefully.

Needless to say, it has not worked out the way we planned.

Nursing homes are all chronically understaffed, so they send the team member that they can most afford to spare.

I am dealing with a comatose old bag of bones, and a


work experience teenager.

'How can I help this lady?' I ask her, and she panics. 'I dunno' she informs me, 'I've just come on duty.'

'Let me have a look at the nursing notes,' I cajole, with infinite patience, and she admits she has forgotten to bring them.

Resigned to my fate, I give up. 'Let's take her back and ask someone who can find their arse with both hands, shall we?' The teenager nods with relief, and trips over her own feet on getting up. 'Just sit on the bed with the patient. It will be quicker'. We hurtle over the road, with cars screeching to emergency stops on both sides.

Dr Phil Peverley is a GP in Sunderland

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