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At the heart of general practice since 1960

Failures of open-access endoscopy

GPs are inundated these days with requests from patients stating they are 'fit'. Fit to do what? Well this can be anything from unaccustomed exercise, flying transatlantic with COPD, swimming with dolphins despite a neoprene allergy, or taking up bungee jumping the same week as seeing an ophthalmologist regarding flimsy retinas.

All of these are impossible to state but are ingrained in society and at a tenner a time easy to generate on an idiot-proof meaningless form of words on a template. I did so many this week it got me thinking about politicians. Should the Secretary of State ­ past, present or future ­ be required to get such a letter from their GP?

Laughing stock

John Reid became the laughing stock of the primary care community after stating that under New Labour consultation times had dramatically soared from nine to 14 minutes. This was stated in earnest on Radio 4 and was claimed to be an average! Unfortunately for him it was based on a survey from Cornwall, which I would politely suggest was rubbish or at least flawed and very dubious.

Every Q&O veteran knows that if you don't clear your last patient of the day as left until the next morning, it gives them a consultation time of about 14 hours. This nicely averages out the carnage of the rest of the day.

While GPs may sometimes sit back during tired-all-the-time consultations and plan their holidays or even make a mental note to discuss the removal of consultation room chairs for patients at the next partnership meeting. John Reid said: 'It's not long enough yet and we will add more.'

I would suggest that his grasp of the finer details of primary care would not merit a fitness to govern letter.

Feeding frenzy

So the opposition parties must be rubbing their hands in glee? Well, er, no. A recent proffering from the Conservatives contained a press release with plans to improve the quality of life for five million asthma sufferers. Andrew Lansley, Shadow Health Secretary, said: 'Labour's target culture has pushed the management of chronic conditions to the margins of the NHS.'

Now correct me if I'm wrong, but what the hell have we all been doing over the past 18 months? In fact over the next few weeks all of us will be pursuing a keen chronic disease feeding frenzy.

Surely the Liberal Democrats have got it cracked? Well have a flick round their website and see if you can find health policy! My only finding was a 14-page speech from Paul Burstow, Shadow Health Secretary, promising lots of cash for social nursing care.

I suppose if you don't have many policies you can't have them criticised. His letter can wait while I go and price up one of the local nursing homes as a business venture.

I invite all of the above to spend a Monday morning surgery with a GP of their choice to get their fitness to be Health Secretary letter.

Dr Andy Jones is a GP in Stamford, Lincolnshire

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