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In praise of pauses

Stop. Just hold it right there. Go no further. Or, to put it another way, ‘Pause’. It’s the de rigeur activity. Or inactivity. Pausing: doing nothing, but with the implication that you’ve been doing something and you’re about to do something more. I like the concept of pausing. I do it between patients routinely. And I might even start doing it during consultations. Just by holding up a hand, a hand which says, ‘Stop right there, between symptom number 7, ‘dizziness’ and symptom number 8 subsection i) ‘that trembly feeling where my whole body feels like it’s shaking inside, the other doctor said it’s my nerves but it isn’t’. During the pause I will shut my eyes because it’s just possible that, if I wish hard enough, when I open them, the patient will be gone.

It doesn’t work – the patient’s still there and is already onto symptom 8 subsection ii) ‘and when I get it I can feel my bladder vibrating’ – but no matter, that pause helped. It’s like a brief intervention session of CBT.

Anyhoo, everyone’s at it. We’ve had the pause in the health bill. We’re having a pause in the CQC registration plans. And now we’re to have a pause in the systematic dismantling of PCTs. That’s a lot of pauses, about as many as in a sackful of cats.

Now then, children. What do people normally pause for, exactly? Think about it… pause for… pause for… for… yes, you’ve got it. Thought. That’s what people pause for. Which just goes to show that wacky ideas like commissioning, CQC registration and the decimation of PCTs hadn’t been thought through properly in the first place. That’s why they now require pauses.

And I’d like to suggest that we apply the pause policy to revalidation. Apparently, the pilots have proved 'unworkable', a story which I’m sure has come out of a clear blue sky for most of us. A story which would never had happened if someone had put any thought into revalidation in the first place and realised we didn’t actually need it.

Doubtless this will lead to further delays. And it’s had lots of delays already: it’s been ‘guaranteed’ to start ‘next year’ for at least the last five years. Those delays would be ‘pauses’ in new money. So let’s have a really nice long pause for revalidation, while we all think about what we’ve done, or at least, what they’re trying to do to us. And maybe, if we all closed our eyes and wished hard….

Dr Tony Copperfield is a GP in Essex