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The perfect end to a perfect year

It’s the end of another wild, wacky rollercoaster year in general practice. And two recent events neatly epitomise why I’ve spent the majority of it feeling as though I’m being beaten with a plank.

It's the end of another wild, wacky rollercoaster year in general practice. And two recent events neatly epitomise why I've spent the majority of it feeling as though I'm being beaten with a plank.

First, I received from my local PCT a package of documents which I think are aimed at discouraging acute referrals from GPs. I say ‘think' because here, verbatim, is the first para of the ‘Winter Planning Charter': ‘The commissioning PCT will not become involved in operational issues on a day to day basis, and will only become involved if there is a significant lack of co-operation at the interface which requires robust facilitation due to system failure (as per the escalation policy).'

The fact that I have no idea what this means owes a little to the fact that I've just knocked back – for reasons that will become apparent – a bottle of dodgy Christmas wine from a patient, but a lot to the fact that this ‘statement' can only be the product of a random jargon generator.

Anyway, buried in the 70 odd pages of turgid dross is a helpful poster entitled, ‘Admission avoidance', which I guess gives the game away. It lists a number of scenarios where I should STOP (their word and capitals) and THINK (ditto) – as though I'm a child about to cross the road in front of an artic. In essence, there's a whole load of diseases I can manage in the community now, presumably with the help of some Crisis Creation Team or other.

Fine - as in ‘Fine, I'll develop an Admission Avoidance Avoidance Strategy'. Meanwhile – and this is what had me reaching for the bottle – I read that an ‘NHS chief' is advocating GP pay cuts for the benefit of society.

In support of her plan to don Lincoln Green and use a band of Merry Men to nick our wallets, Dr Linda De Caestecker cites a couple of GP heavyweights who, supposedly, have had similar ideas themselves. Well, call me cynical, but I've noticed that people tend to come over all morally higher-plane and socially conscious when they're nearing the end of their career and mortgages are paid off.

For the rest of us, a decent income goes some way to offsetting the stress and bananaskins of the job. Coming over holier than all other professions will not solve societal ills even if it does salve our conscience. Besides, if I wanted to be a fluffy bleeding heart, I'd have been a charity worker.

So there we have it. On the one hand, we're to work harder. And on the other, we should give our money away. We're being squeezed on both sides and my skull feels the same way. As for our rollercoaster ride - the way things stand it looks like the only way is down.

Copperfield: Filled with Christmas cheer

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