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At the heart of general practice since 1960

Phil's bored stupid – he's doing a stint at the walk-in centre and wonders why it's so quiet

A walk-in to boredom

I am bored. I'm profoundly bored, so bored that I'm actually contemplating doing a postgrad GP distance learning module online; that's how bored I am.

I'm sitting in our new super £5.5m purpose-built all-singing,

all-dancing walk-in centre. I'm supervising my registrar. To qualify as a GP, she has to do six evening out-of-hours sessions of three-and-a-half hours. I practically tape my mouth to try to stop myself from coming out with 'When I were a lad'-type homespun wisdom, but I can't stop myself.

'When I were a lad, I spent a year doing one in five nights and weekends on call!' My registrar rolls her eyes; she has heard it all before. 'In my day, we knew what being on call meant! Sleep? I used to dream about having some sleep!' My registrar gently points out that the amount of out-of-hours training she is receiving is entirely appropriate for the amount of out-of-hours work she expects to do in the future – none. She has a point.

In this building at the moment, two different services are running. Three GPs are working for Primecare, who are taking the calls that go to GP surgeries. It is so deathly quiet that we suspect the phone mustn't be working. Down the corridor is the nurse-led minor injuries unit, or 'walk-in centre', who take a small selection of stuff that used to go to A&E.

It's a very small selection. There is a list of stuff they will not deal with pasted up above the reception desk, and it's a comprehensive one. No head injuries, no injuries below the wrist or ankle, no pyrexial patients, no rashes, nobody who has had an antibiotic in the past week, no babies – the list goes on.

Interestingly, nobody is immediately turned away. The patient is interviewed, all details taken, paperwork filled in, and only after 20 minutes of form-filling are they informed they are at the wrong shop. Officially, they have had a consultation, even if that consultation consists of 'You've come to the wrong place – go away'. A cynic might suggest this process is purely and simply to get the numbers up and justify the existence of this expensive misuse of primary care resources. So I will suggest just that.

Ten o'clock, and there are apparently no patients in the building. Nobody in our waiting room, nobody in theirs. I count 19 cars in the car park. As I gave my registrar a lift to work, that means there is a bare minimum of 20 people 'working' at this moment.

We have three doctors, two reception staff, two security guards, a cleaner, and a young lass striding about with a clipboard on which she apparently writes nothing. The other 'workers' are doing sudoku. The room in which I am writing this is well-appointed. There are two TVs and a video machine, a gym-quality running machine still in cellophane, and a bunch of other fitness equipment. None of this shows any sign of having been used.

It's the end of the evening, and of the seven patients we have seen, six of them were referred up to us by the nurses at the walk-in centre. Each of these has, on paper, had two consultations. Sunderland PCT has just had approval for the funding of another such out-of-hours centre in Washington. It will cost £9m of your taxes.

pulse@cmpmedica.com

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

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