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At the heart of general practice since 1960

Burning us all at the stake

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In 1604, James I of the united kingdoms of Scotland and England (previously James VI of Scotland) passed a new Witchcraft Act, which was harsher and more severe than the 1562 Witchcraft Act of Elizabeth I. 

Witches, in effect, became even less of  a good thing than they were before. Matthew Hopkins, England’s first Witchfinder General, probably didn’t take that long to work out which side his bread was buttered on. I’m guessing it was within five minutes of finding out his job title. No witches, he’ll have realised, equalled no credibility and no pay. 

Unsurprisingly, then, Hopkins managed to find about 200 witches in East Anglia alone (at a guinea per pointy hat). Those 200 women were hanged or burned. No elderly lady with a cat or a prominent facial seborrhoeic wart could rest easy. 

It might appear crass to segue from this historical horror to our friends in the CQC. After all, the CQC itself has said it’s not in the business of witch hunting. And yet the thought arises: will the CQC be able to justify its own existence if no witches are a-burning? 

A friend of mine had his CQC inspection the other day. They checked for maggots, forgotten corpses in corners and seeping piles of out-of-date controlled drugs, but found none. As you’d expect. 

Eventually, they settled for: ‘Where are your disposable sterile paper cuffs for use under your desktop sphygmomanometer?’ My friend theatrically patted his pockets. ‘I guess we must have run out.’ 

This wasn’t a random brain-fart of  a question, because the inspectors asked his colleague the same thing. 

‘What will you do about that one then?’ the CQC asked my friend. 

‘I’ll do a risk assessment and get back to you,’ he said, brilliantly, and everyone heaved a sigh of relief and proceeded to leave the building. Job done. 

After he told me about this episode, I was minded to have a look at my own sphygmomanometer cuff. It’s made of some sort of silvery material. After the first 15 years it was looking a bit grubby and frayed, so I took it home and washed it with my pants and shirts. It didn’t look any less grubby afterwards so in the subsequent five years I’ve never washed it again. It still works. No one has yet died. 

A stupid question can often generate some sensible thoughts, though, so I began to wonder what else in the practice might constitute an infection hazard.

The bogs – now they must be high on the list. The door handles? The magazines? So what do we routinely sterilise? Nothing, that’s what. 

My friend’s ‘risk assessment’ was a classic of its kind and it went as follows. Problem: infection risk from blood pressure cuffs. Retrospective analysis: as a GP of 25 years, a trainer, an educationalist, and after a Medinet Google literature search – never heard of any infection risk from blood pressure cuffs. Prospective analysis: ah, come on! Action: nowt. 

Then he typed this into his appraisal document. I hope we might all learn from his expertise. 

Readers' comments (11)

  • David Bush

    Superb article - get it published in BJGP. It's better than most of the dross in there.

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  • Peverley for health secretary!

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  • In the light of this article all our patients are to be issued Forensic Microguard 2000 SOCO white suits on arrival to protect them from the fetid grime on our medical equipment.

    Will this satisfy the Witchfinder Pursuivant?

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  • Bob Hodges

    I look forward to asking the following question:

    "So if no one has yet caught an infection from the floor in this building during more than 70 years of conituous use as a GP surgery, tell me why I have to spend 20 grand on new lino that goes half way up to the ceiling when we're moving to a new building in 6 months.?"

    However, the CQ has unwittingly provided us with a 'home visit deflector' i.e. divert to coming to surgery:

    "Madam, If your front room was an appropriate place for me to practice medicine, then the CQC would be asking me to spend 20 grand on lino as awell as other expensive kit - like 'lighting' for example'.

    Look for seocndary gains where they exist!

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  • As a matter of urgency all pubs clubs and hotels must be inspected . They are purveyors of alcohol -a drug dispensed by unqualified staff and allow hazardous pursuits such as the hurling of sharp pointed objects while intoxicated. Dominoes are a cesspool of infection and the toilets frequently have wet floors secondary to the diuretic effects of the drug and its impairment of ones ability to aim (see darts ) .

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  • CQC FO

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  • Could the CQC not ask the CCG to fund those for us or should it be funded from our ever increasing fat pay packets.

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  • Paperwork, increasing LES and DES's, ever increasing targets, same or less staffing, technology were meant to use that doesn't even work properly yet like cqrs, mandatory training, all what we have to do week in week out, not even taking into account patient actual care! patient care increasing hmmmm, maybe on a piece of paper but certainly patient time is decreasing, no wonder newly qualified gp"s stick to locuming or salaried, more actual patient care, less paperwork, less stress, more potential earnings....we are in a worrying world at present and now they chuck cqc at us! Sometimes too much can increase quantity but decrease quality.....Mark D

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  • Is there any wonder we are running out of GPs? The sooner there is no one left the better. Who would want to work in this nightmare.?
    Here is me thinking everything is evidence based. So, thousands of people have got ill from cuffs, I believe!!
    Au contraire, increasingly research shows that exposure to bacteria is essential for proper immunity.

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  • Richard Ansell - 8.22am
    All pubs, clubs and hotels are regularly inspected by environmental health officers who can close them down instantly if they don't meet certain standards. I expect they moan a lot too.

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