The talk among the Jobbing Doctor's peers is all about retirement
People of my era are talking of retirement.
Some have already gone, but many are merely planning the optimum time to go. The first question that is asked when the class of '75 meet is - when are you going to retire?
I really enjoy my job. I believe that, generally, the practice I work in is an excellent practice with high-quality medicine and teaching. This is all that I have been working towards for many years, and having achieved a good position, then I would want to enjoy that fact for a few years.
However, all the talk is of retirement. Why is that?
The job remains pretty much the same. When I am sitting in a room with my patient - on a one-to-one basis - it could be thirty years ago. I still listen to the history, do an examination (if needed) and use these skills to reach a diagnosis. Granted, the computer sits there like Big Brother (Orwell, not TV) glaring at us and instructing me what to do. Otherwise, things are unchanged and unchanging.
The change is outside, and is almost entirely as a result of government activity. I use the word change advisedly, as change for change's sake seems to be the default position of government: any government. I don't dislike it, if I feel that the change is in the best direction, and motivated by the right reasons. I remain to be convinced of this.
Commissioning is the elephant in the room. We are being told that huge numbers of entrepreneurial GPs are gearing up for the massive upheaval of taking on commissioning - and that there is real enthusiasm for this project. This is particularly interesting as my home PCT is on the list of PCTs that are at the forefront of change in this area. I just don't see it. It feels like a damp squib to me.
I can pretty much cope with commissioning, however successful or not it may be, as it won't impact on me.
I think revalidation is pernicious. It has changed the emphasis of assuming that a professional person behaves professionally (as 99% of us do), onto the premiss that we have to demonstrate that we are professional people. We have to spend time compiling lists and evidence to prove that we are who we are so that Government-appointed apparatchiks can sit in judgement on us.
Revalidation is an expensive exercise in forcing professional people to demonstrate their worth, simply because the authorities ignored the warning signs about a mass-murdering GP. As Emerson says, 'hard cases make bad law', and revalidation is bad law writ large. I object to having to pay for what some hand-picked judge thinks is a good idea. I object to spending time rather than money. It won't work, of course: it is not (to use the favourite political phrase) fit for purpose.
Finally, we are seeing pressure on pensions. One of the reasons I decided to work in the NHS was the pension. It is a good one that I have contributed to for 36 years. I regard the beneficence of my pension as deferred income. It will hasten my retirement if the tax rules on pensions are changed. I would regard that as a breach of a contract between myself and the state.
So; commissioning, revalidation and pensions. These are the three horsemen of the apocalypse for me. The fourth is my own health which is, fortunately, robust.
These are the reasons for retirement. It is approaching in the mists of the future.
I welcome it.
The Jobbing Doctor is a general practitioner in a deprived urban area of England.Click here for more from Jobbing Doctor Jobbing Doctor