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CAMHS won't see you now

I used to love this job

Phil remembers the time when he felt an insane devotion to the NHS – but all that's changed

Phil remembers the time when he felt an insane devotion to the NHS – but all that's changed

There were two depressing items in the news this week. Actually there were dozens, but I've only got 700 words to talk about them, so let's concentrate on the real stinkers.

Tony Blair, in a speech to the NHS Confederation, defended his NHS reforms, on the grounds that they will lead to better patient care, and called on doctors and managers to sell the reforms to the public. Well Tony, not to mince words, you can bugger off. Your managers will no doubt say what you pay them to say, but I won't.

No doubt some of the 'useful idiots' in our profession will spout as much optimistic blather as will earn them their knighthoods, but those of us who have to deal with this shameful, wasteful mish-mash of ill-thought out and frankly dangerous dumbing down on a daily basis reserve the right to tell the truth, if asked.

Second, the Department of Health has moved up a gear in its campaign to renege on the GP contract it was so keen to negotiate. The bayonets are unsheathed. We earn too much, and they are going to claw it back.

Apparently, we should have invested more of the money into developing services. It makes me want to weep. Leaving aside for the moment that 80 per cent of my supposed pay rise has gone straight back again in various forms of tax, this is a staggering new concept in the field of employment theory. Using the same logic, if teachers get a pay rise they should be spending it on school textbooks. A fire fighter shouldn't be spending it on his mortgage, it should be going towards getting his fire engine turbocharged.

I used to love general practice, and I had (in retrospect) an insane devotion to the NHS. It used to work, after a fashion, and I was proud to be part of Nye Bevan's revolutionary social experiment. Now I hate nearly all of it, and nearly everyone who meddles so irresponsibly with it. The only time I enjoy it is when I am sitting face to face with one of the punters this whole creaking dinosaur is supposed to be there for, and doing the job I was trained to do.

I do my best to solve their problems and we negotiate our way through the bureaucratic labyrinth of secondary care, phoning and writing and cajoling and calling in favours and bending the rules in order to get my patients what they need and deserve.

There's so much to be depressed about. The PFI schemes that have hopelessly endebted our service for decades to come, the fact that the NHS spends more money on the salaries of management consultants than it does on consultants, the fact that there are more NHS managers than there are beds, and yet it is practically impossible to get hold of either of them. We have endless policy initiatives on bullying and discrimination and smoking bans, day-long seminars on empowerment and equality, and yet only one antiquated MRI scanner and no one to type up X-ray reports. Where is their sense of priorities?

Sometimes I think it can't be as depressing as it seems, and today I decided I would make an attempt not to be so negative. I would make a list of all the things that enthuse me, all the things that make it all worthwhile and keep me committed. All the good bits. After half an hour I came up with the following list: 1. The Who have got a new album out; 2. Er, that's it.

Dr Phil Peverley is a GP in Sunderland and MJA Columnist of the Year

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