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At the heart of general practice since 1960

In the first of her new weekly diaries, Dinah Roy ponders on the future of PCTs – and struggles with the hair straighteners

Monday

Slow start to surgery for 2007 – great! More time to play with new computer, one of many legacies of last year. What else did 2006 bring? Surgery extension – but snags still evident; PCT mergers (five into one); and best of all: my new hair straighteners!

New Year's resolutions? Hope to end my traditional annual speeding fine for starters, although suspicious-looking police camera van around recently (it's difficult to be vigilant when late for surgery). Also looking forward to resigning from gym – probationary six months finally over, can stop feeling guilty about never going and reinvest £50 a month in

anti-ageing creams.

Receptionist calls – terminal in room 2 is locked, can I sort it out (where is practice manager?); three patients waiting.

Tuesday

Damn. Late for PEC. Burned thumb on hair straighteners. Plus daughter's mock GCSEs start today: great drama and panic. God knows how we will cope with the real thing – probably gin (must get some tonight).

She's announced her intention to become a psychiatrist, no doubt inspired by our highly normal family. Apparently

A-level textiles is now an acceptable qualification for medicine. Suppose it might help with all that basket making...

All-morning discussion about future of PEC – Department of Health consultation requires a response but they've missed the point. How can you redesign a committee with no obvious purpose?

If practice-based commissioning works properly – and is implemented effectively – it will be much better at clinical engagement and leading service redesign than most PECs ever were. PBC leads should work with PCTs to sort out where we're all going. So all the PCT needs in addition is clinical advisers for approval and governance – which must mean a long, drawn-out and tedious death for most PECs.

Wednesday

PBC group today. Latest problem is retinal screening; a new camera-based service is cracking up with inadequate admin support and the old optician-based service is now closed. Diabetics will miss eye tests and practices will miss QOF targets: big trouble. Try to get old system re-established but there will be funding implications.

Still haven't caught up with pre-Christmas e-mails but inbox blocked with megabytes of business cases for prioritisation. Aargh!

Friday

Busiest surgery all year. Eleven tearful, one suicidal thoughts. Everyone depressed and miserable. Why? Families. Spending time together over Christmas has proved they can't stand one another, despite a final big effort for the kids.

Not sure how many of them realise the average cost of divorce is £28,000. Well, that's not going to help eradicate poverty. Thank goodness we have Sure Start to fall back on for the free stair gates. (Note: tell daughter to reconsider. Law much more appropriate with those A-levels, plus she'll need the money.)

Late home – fortunately still some gin left; did I really drink all that?

Dinah Roy is a GP in Spennymoor, County Durham. She is also chair of Sedgefield PBC group and a member of the joint PEC of County Durham and Darlington PCTs

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