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At the heart of general practice since 1960

Pensionable profits form is a trap for Northern Ireland GPs

I'd like to introduce a new phrase to clinical practice. I'm a bit 'tooled off' at the moment. For the uninitiated, read on to get your points. Toolkits, to help us answer long and boring questionnaires, have been raining out of the sky like a plague of locusts. They are supposed to assist the process of checking a whole range of services to ensure we're not all skiving. PCTs and the Department of Health are fretting about coughing up cash, so have devised ludicrous and bureaucratic avoidance scams. So are we following the high trust, low administration path of mutual benefit? Not a 'tooling' chance.

A whole new wave of nonsense paperwork seems to have sprung out of uncertainty in middle management. Imagine yourself beavering away for the middleofnowhere six-wolds PCT, with responsibility for meaningless and rather grey areas of clinical practice. How on earth do you go about checking that the 46 practices in your patch are compliant with your 93 standards in computing, hygiene, waste paper disposal and paper-clip orientation?

Simple laziness

Put yourself in the PCT's shoes; it's frightening, but bear with me. You've got three choices. Option one would be to visit the practices, checking yourself with a friendly constructive chat. Option two would be to check a small sample yourself to see if the high trust system is working, and option three would be to devise a 46-page questionnaire with a toolkit so that practices can report it all themselves.

No degree in rocket science is required to see what the hordes of PCT gnomes working in windowless offices decided. Option one is clearly ludicrous as all PCT mission statements dictate that no one should ever leave base, especially to tour the patch, unless in dire emergencies or coffee shortages. Option two does not achieve the second prime objective of abdicating responsibility and accountability as often and extensively as possible. That leaves option three. Yes, the reason why every GP is being spammed by toolkits is laziness.

My prescription

Buck-passing is our favourite national sport. The Government tells the PCT to make it happen. PCTs devise a plan and tell GPs to get on with it. Does it stop there? No, to get your cash you have to audit your results and submit pages of answers aided by a toolkit, only to find most of the cash got spent on new computers for the PCT's bean counting department. Beware not to raise any queries in a PCT appraisal. You can bet your reply will come in the form of a link to www.impossiblelongdocuments.com.

If someone sends you a toolkit, you now know why. It is either because they can't be bothered to check themselves, or are passing on their burden to you.

I'm building my own toolkit. It will consist of a phone number practices can give their PCT. On it will be an answerphone message saying 'Hello, doctors' surgery informed'. That way, all PCT boffins in moments of panic can phone and ease their conscience.

Dr Andy Jones is a GP in Stamford, Lincolnshire

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