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Passing the buck

Nurses, paramedics, elf 'n' safety - they're all expert at covering themselves. GPs could learn a lot, says Copperfield

You know me. I'm not one to complain. I've just had to replace the roof here at Copperfield Towers as a matter of some urgency – sitting here in my study with water dripping around the 240v/13A bits of my office equipment wasn't really compliant with current Health and Safety at work regulations, and when the risks are to my own health and safety I'm prepared to leave my usually cynical views about them to one side.

You are supposed to inform the local council several weeks in advance if you're thinking of having your roof replaced. But if it's a choice between a slap on the wrist from the town hall and an inadvertent defibrillation when I reach for the desktop lamp, I'll take the slap every time.

So I have a lovely new roof, and I've had a visit from the council's lovely new Buildings Inspector. She was perfectly happy with the replacement timbers and tiles and, after trousering a cheque for £280, promised me that she'd be in touch.

And I've just opened her letter. It includes a 'Certificate of Compliance' - and it reads: 'This Certificate provides evidence - though not conclusive evidence - that the work has been carried out to an adequate standard...'

So what exactly have I just paid out the thick end of £300 for? If you were buying my house, how reassured would you be by a certificate inconclusively giving my building works the OK? This piece of paper is worth about as much as the piece of paper it's written on. And coincidentally, it's just about big enough to cover her arse.

This morning I got a call from the local granny stacker. One of their younger inmates was having a dizzy spell and had fallen over. The paramedics had been in and given him the once-over and the all clear, but, how would I feel about coming in to see him? Now.

Unhappy. And here's why.

If Mr Bloggs had lost consciousness for any length of time then he needs hospital admission to find out why - ambulance, not GP. Secondly, if there's any suspicion of a broken bone or serious injury as a result of the fall, ditto, I don't have X-Ray eyes. Lastly, why did he fall in the first place?

If he's always feeling dizzy and falling over, then that's a topic to discuss at the twice weekly ward round - nine times out of ten it's been investigated thoroughly already and the nurse hasn't bothered to read the patient's medical record. So, my problem, maybe. Urgent visit, no.

In this case, as you'll surely all have guessed by now, Mr B was fresh out of hospital after a three week stay to investigate the causes of his dizziness. He's sporting a nice new 'If I've got Meniere's Disease has he got mine?' T-shirt and a prescription for betahistine, 8mg t.d.s. which obviously needs doubling.

All too often the nurses call the paramedics to cover their arses (which is their default position) and the paramedics call the GP to cover theirs (ditto).

And I wouldn't mind, but the handmaidens and the green goblins are always banging on about their 'professionalism' - professionalism that seems to absolve itself of all responsibility.

Which is why I'm going to get some certificates printed. 'This certificate provides evidence, though not conclusive evidence, that this could have waited until tomorrow...'

'Sick Notes' by Dr Tony Copperfield is out now, available from Monday Books.

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