In the lead up to my retirement, I attempted to get the remaining practices toform a closer bond. By that I didn’t mean they should lose their individual identities as it was clear that patients liked them as they were. What I was aiming for was to create closer financial and organisational bonds so as to give the practices more clout and put them in a position to negotiate a better deal for SWF.

John Phelps, who used to be the Chair of the PPG at ‘The Practice’, managed to get NHS England to admit that it would save £180k per annum from the closure of The Practice – so if we could access some or all of that it would mean significant improvements in patient care would be possible

We had worked together well (as the ‘independent practices’) during the time that the PCT was throwing every benefit it could at the practice it ran in an attempt to give it an advantage whilst discriminating against the patients of the other practices. We wrote joint letters in an attempt to obtain a distribution of resources that was fairer to our patients.

I delayed retirement for quite some time to see if something could be worked out – but, sadly, it didn’t come to anything. The Greenwood Surgery funding, whilst better than it was, would have still acted as a drain on the other practices.

Meanwhile there were discussions about what services would be available in the new medical centre. There had been talk over the years about what was needed in the town and these often centered on making improvements that would enable the residents to get the same level of service as their pets – see Scott Nimmo’s demonstration at https://youtu.be/iS2NxRqs0jU?si=Vq94aJN7V2RzCuEw . In Hopeless Harrison’s time there was talk of significant funding to create genuine long term improvements and there was no shortage of suggestions. One of these was to have an x-ray capability and there were at least two radiographers living in the town who were prepared to give their time … which put us in a strong position. Furthermore, the digital age was gaining pace so sending the images down the line for reporting was feasible. A great deal of hot air was created during discussions about this and other suggestions … but there was little to show for it.

With the opening of the new health facility there was, as previously mentioned, a promise made that all the services available in the town centre would be transferred. Would this be a bright new dawn when the plan to bring care in its many manifestations closer to the people would be also realised? We waited with baited breath to see if this would come about.

There was still clinical work to be done. Since the time our wonderful team of district nurses was torpedoed by ‘management’ I had become very involved in ‘end of life care’ for patients. (This had hitherto been dealt with very well by the nursing team.) Shortly before I retired, however, I had personal experience of less than perfect terminal care. I was asked to see a young chap receiving palliative care as he’d run out of treatment options. He was in a lot of pain and there were other problems too. Normally I’d have simply dealt with the situation myself but I was in a difficult situation as he was a temporary resident (registered with another GP in another town) so it was difficult for me to ‘muscle in’ … and, to make matters worse, I was not going to be able to follow him up. He’d been involved with a nearby hospice, however, so I thought it best to touch base there. I spoke to a call-taker on the phone who said: “I’ll pass the message on to Dr Jonathan”. (In the good old days you’d talk to the doc direct rather than rely on a garbled interpretation – and, for all I knew, Dr Jonathan had never been involved with the patient and knew nothing about him.) I then got a call back from the messenger which was presumably a garbled version of what Dr Jonathan had said … and wasn’t at all helpful. This episode didn’t leave me filled with confidence. The Daffodil Standards had just been introduced but there’s no point in having guidelines unless you follow them.

At last the day of our retirement dawned – Sue and I having decided to retire on the same day: April Fools’ day 2019 – shortly before my 72nd birthday. We’d started the practice together and so it seemed appropriate to finish together. She was the uniquely reliable and supportive ‘partner’ throughout … but NHS ‘doctor centric’ rules didn’t allow her position to be formalised. Our daughter, Laura, mounted a selection of photos of Sue, me and the family taken over the years on boards in the waiting room. There were lots of cards and presents reminding us that we’d known many of our patients for decades – since they were kids and had grown up to have their own kids.

The next step was to plan a retirement party in the Village Hall so we could say our farewells to as many of our patients as possible – more of that in next week’s exciting episode … and to try to deal with the concerns of the patients who’d contacted us during the final days. The big question to be settled was: “Did the current plan for healthcare provision in SWF work? Was it wise to close all the medical facilities in the town centre and make a new building on the periphery of the town the sole source of medical services? Would this be a sensible way of providing the town’s healthcare needs?” The elderly were most concerned – and it seemed to me that the town’s voice had yet to be heard – for a long time the ‘communications’ people didn’t communicate and what had happened since had been somewhat limited in its scope. If what was proposed was an adequate solution, well and good. If it wasn’t, we should at least draw attention to it. With that in mind I set up a survey.

Dr. John Cormack