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At the heart of general practice since 1960

Dinah's credit card spending sparks a brilliant-on-paper idea that rather backfires...

Monday

Practice manager back from holiday – hooray! Tell her about my new credit card especially for clocking up air miles and we get thinking: how about a loyalty scheme for patients, awarding points for self-care or alternatives to hospital referral, to be redeemed against choices from healthy lifestyles catalogue, funded through PBC? Would local authority take part and include gym membership? Or even council housing applications?

Get bogged down in details of business case, late for surgery. Mrs G turns up full of hell. She'd saved every penny for the holiday of a lifetime only to have it cut short by a grandson's illness. Now the insurance company won't pay. Can I get their money back? I commend her fortitude in attending (being on the sick with immobility) and agree to help, then seek her views on the proposed points scheme. Fatal error. Who is responsible for all the wrongs on this earth? Apart from insurance firms, it's The Council.

Wednesday

Just in time for PBC meeting; find a note on my seat: 'Strong, Healthy, Safe, Attractive'. Corny chat-up line or what? Before I embarrass myself by demanding an explanation, the public health person announces it as the new local authority mission statement. Of course. Leads nicely into discussion on next week's joint meeting with LSP (Local Strategic Partnership). Most people neither sure exactly what it is, nor how long it will last. Finish with anxious discussion about forthcoming Government review of NHS. Can practice-based commissioning survive integration of primary and secondary care? Can practices survive competition? Gord help us, says the Daily Express (waiting room copy).

Home – children ask where we're going for summer holiday. Mumble that it's in hand then spend hours frantically searching internet. Have enough air miles to get to Glasgow but kids unimpressed. Obviously need to increase credit card spending.

Friday

At PCT, interrupted by call from surgery – Mrs G requesting urgent visit for breathlessness. Rush off but car splutters to halt. I don't believe it! No petrol. Walk to nearest garage – they don't take new credit card. Fortuitously flag down public health person who drops me at Mrs G's house. Sort out her panic attack and sign insurance form. Phone practice manager – yes, she will pick me up in return for promise to get council off her back. Apparently Mrs G has complained about proposed points scheme on grounds that she is entitled to free gym membership anyway, so why should she do self-care? Apologise to anyone who will listen.

Go to travel agent and hand over credit card. One holiday for four and don't spare the horses.

Dr Dinah Roy is a GP in Spennymoor and chair of Sedgefield PBC group

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