After retirement, as well as doing some GP work, I also did some sessions at Chelmsford Prison where the Porridge feature film was shot. This was something I’d never done before and it struck me as being potentially quite interesting.
Like all rookies I thought I might spot potential nobody else had seen in some of the inmates and set them on course to make something of their lives (thereby earning plaudits from all and sundry) … but, needless to say, that didn’t happen. It was certainly a steep learning curve. Many had mental illnesses and/or addictions which ensured that, when they were freed, it wasn’t long before they arrived back again. Given the phenomenal cost of incarcerating offenders, the system could do with a fairly drastic review … although, having said that, better minds than mine have tried and failed.
When Covid was just beginning to hit the headlines it soon became apparent that it was going to spread like wildfire. I took a trip down to London by train in the very early days and, although common sense dictated that droplet spread was going to be an important means of transmission of the virus, all the windows (yes, they still had ones that passengers could open) were closed despite it being a mild day. Moreover, several passengers were coughing all over each other without even adhering to the good old ‘coughs and sneezes spread diseases, catch them in your handkerchief’ advice.
It soon became apparent that people working in retail were very exposed. It was estimated that they had a fivefold risk of Covid-19. Supermarket managers were very slow to take any precautions. The feedback was there was reluctance to deal with the threat – and that was certainly my experience. The most proactive shop I encountered was Mr Gees Foundation’s charity shop where they quickly took all the necessary precautions to protect the staff. I produced a training video for them so that new members of staff could be kept in the loop. While I was at it, I also recorded a Christmas song to advertise the shop’s wares given that Mister Gees (aka Douglas Green) has done so much for SWF over the years.
Sue and I both applied to be vaccinators as soon as the Covid vaccine started to be rolled out. The crazy aspect (about which virtually all clinicians complained) was that we were treated as if we had spent our entire career designing tower blocks or stacking shelves in a supermarket. In fact we’d both spent decades giving vaccines – more so Sue who had given all the childhood vaccines and travel vaccines (etc) including some fancy ones like yellow fever. She could have walked in on day one and started dishing out the vaccines safely … whereas we ended up getting loads of forms to complete and online courses to do. Needless to say, my patience didn’t extend to this bureaucratic hurdle …. but Sue, who has infinite patience (which explains why she’s stayed married to me for so long) did all the courses uncomplainingly and was then able to undertake numerous shifts.
I also did some oncology sessions at a local hospital … not that I have any particular expertise in that area despite presenting a Channel Four documentary (‘Concerning Cancer’) on the subject.
Looking back at my time in practice in SWF, the best ‘partner’ was Sue, an amazingly good ‘old school’ nurse, who was there on day one (running up and down the stairs with the medical instruments I needed whilst waiting to go into labour, fielding phone calls from patients worried about their screaming babies whilst her baby was screaming every bit as loudly in the background) – and she remained the ‘power behind the throne’ until the final day. The best ‘doctor partner’ was Hilary Allan who, after doing a great job for a decade, was, sadly, whisked away from SWF by her then husband to set up an ‘aesthetic medicine clinic‘. (I won’t name the worst).
As for lessons learnt, we spent a great deal of time trying to create improvements, attending hundreds of meetings and expending enough hot air to be responsible for around 1.75% of the rise in global temperatures since the industrial revolution … with little to show for it. The management of the NHS is less than perfect – and it was particularly bad in this area. If I had my time again I’d have followed the policy operated by Medac, SWF’s original ‘patient care improvement’ organisation. It just went ahead and started new services – like the first ‘blood taking’ service in SWF (before which patients had to travel to a local hospital for blood tests) and charged for it. The fee was something like 75p to cover the costs. This got round the difficulty of proving the need for additional services to unsympathetic and ill informed managers who took the view that: “They’ve managed without it so far – so they’ll be able to manage for a bit longer”. When Medac proved there was a need, the NHS was forced to take it over and run it free of charge.
If I’d continued along these lines I think we could have succeeded in setting up an x-ray service, for which there had been requests throughout my time as a GP whenever there were discussions about improvements. When I came to SWF I brought with me a small dental x-ray ‘machine’ which I’d used during my days working as a dentist … but ended up giving it to Scott Nimmo when he was setting up his veterinary practice. He used this as a stepping stone to investing in more sophisticated and versatile imaging equipment as part of his plan to ensure that the residents’ pets had a far more comprehensive service than the residents themselves. One of the SWF dentists (TC) also had some pretty amazing X-ray equipment. As time went by the NHS became increasingly hidebound by red tape – so, with the benefit of hindsight, we should have got a move on.
As for the future of the NHS – it’s served us well during my lifetime but during my career attitudes have changed. When I’d just arrived in SWF I was called out in the middle of a surgery to deliver a baby that had decided to come into the world earlier and more rapidly than expected. On arriving back I got a round of applause from the patients in the waiting room. I doubt if that would happen now. The young are increasingly using the private sector (keeping the NHS in the background as a safety net.) Young doctors are increasingly demanding a more reasonable work/life balance. They wouldn’t dream of putting up with the sort of treatment my generation received (as well portrayed in TV series written by erstwhile doctors.) It will need a fundamental rethink to enable it to survive. Meanwhile, my daughter, Laura, a consultant interventional radiologist, refuses to do private work as that would take her away from her NHS patients … so there is hope.
Dr John Cormack