This site is intended for health professionals only

Burning us all at the stake

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 They checked for maggots, forgotten corpses in corners and seeping piles of out-of-date controlled drugs, but found none.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.