You may have a big stick but you don't scare me

Copperfield squares up to the latest 'expert' who wants to revolutionise general practice

Nature abhors a vacuum. So no sooner have we waved a tearful farewell to Baroness Young – she of the CQC and the big stick – than we say hello to Dr Penny Dash, who also has a big stick, and some even bigger ideas. According to reports she is an ‘expert' from the 'influential' 'think tank' the King's Fund.

One of her suggestions is that we GPs should stop wasteful referrals. In particular, we shouldn't be sending our arthritic wrinklies for hip or knee replacements, because these are ‘low value' procedures. Or, to use Dr Dash's words, ‘People have knee replacements and think that they will be running up a hill the next day, but it is often marginal improvement. If we are very brave then we can reduce quite a bit.'

Yes, of course. I refer my crumbly cripples for joint replacements so they can enter next year's London marathon and earn lots of money for Arthritis Care. As opposed to because they're in agony and face a lifetime of opioid-related constipation when they haven't got NSAID-induced melaena.

On that basis, maybe we should bravely stop referring all the elderly visually impaired for cataract extractions. Because they've probably got jumped up ideas about ending up with bionic vision and being able to read a knitting pattern at a hundred paces. Besides, it's more cost effective to leave them blurry eyed so they wander off in front of a bus or something.

Dr Dash does speak some sense, though. She apparently warned that GPs should be more innovative and efficient in their approach considering, for example, ‘group consultations'. Ah, I do that already, marching into the waiting room on cold winter's days and telling the viral, sniffly masses that they can all f*** off home and leave me alone.

I look forward to more expert and influential ideas from Dr Dash – but I think they'll tank.