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The blame culture

Phil says life would be far less stressful if the polititians just left GPs to get on with the job

Phil says life would be far less stressful if the polititians just left GPs to get on with the job

Stress is a double-edged sword. Without it as a motivating force, we might never get out of bed in the morning. It's also an incentive; to alleviate potential stress we are moved to do our job to the best of our ability. We all want a stress-free life. Working hard and doing it right usually means we can avoid this emotional burden.

Too much stress, however, cripples us. An excess of it can make you ill. It's a word that crops up more and more on Med3 forms; I have entered that diagnosis on a sicknote more times than I care to remember. Stress is defined by my dictionary as 'mental, physical or emotional strain or tension', which is accurate enough.

The cause of stress is a little harder to define. What is it that stresses you out at work? I have been thinking about this over the last couple of days, and I have reached the conclusion that we suffer from stress when we are forced to take responsibility for events that are beyond our control.

A patient attends to get the result of an X-ray taken a month ago after he coughed up some blood. The computer tells me that the report is 'pending'. It's not my fault, but I find I'm apologising and getting worked up.

Another patient had his first fit a fortnight ago. He has headaches and visual disturbance and I suspect he has a tumour; the fact that our neurology department feels he can wait until March is not really my problem, but that doesn't stop me sweating over it. What do I tell him? What excuses do I make? I'll phone and I'll write and I'll pull strings and I'll call in favours and I'll probably get him seen in a couple of weeks, but why should this be up to me?

My lunch breaks get overtaken by this sort of anxious catch-up system manipulation. It's rare that I get home for a break in the middle of the day any more, and I see less and less of my sons because it gets closer to their bedtime when I eventually arrive home in the evenings.

A psychiatrist, Professor Tim Cantopher of The Priory rehabilitation clinic, has recently gone on record with his concerns. Professor Cantopher primarily treats patients suffering from stress-induced mental disorders. 'Twenty years ago most of my clientele were business executives,' he tells us. 'Now it is public servants who form the bulk of my practice.'

He is currently treating 44 doctors, but he also has teachers, social workers, ambulance staff and firefighters on his books. He believes that the big change in the past 20 years has been the growth of a bureaucratic 'blame culture' which has been fostered by politicians.

'When mistakes are made by public servants there is routinely an inquiry, followed by the identification of a scapegoat, and then a new ream of regulations, which ends up destroying the service itself' he observes in an article in Public Servant. 'We now have an environment that stops people doing their jobs, leading to a downward spiral of mediocrity and disillusionment.' I'm with you all the way, Prof.

He goes on: 'So please, politicians, get out of our public services, stop making us ill and let us get on with doing the jobs we've mostly been doing well until you came along.' I've got nothing to add to that really, other than a heartfelt 'Hear hear'!

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

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