Plans for the new facility – the CVMC – proceeded at pace and the layout of the new building was agreed (sort of) although, as previously mentioned, the possibility of an additional floor to ‘future proof’ the building was dismissed – and a bay for the breast screening unit and other diagnostic facilities was quietly forgotten. One other gripe is that the position of the building was sneakily moved from its original site to a position right next to a busy/noisy road and the petrol station.

The NHS ‘powers that be’ were very reticent about letting the public know exactly what was going on which led to a certain amount local anxiety and confusion. Letters were written in an attempt to find out a little more about the exact arrangements that were being put in place. Part of the reticence to impart information may have been due to the fact that it had already been decided behind closed doors that all facilities in the town centre would be shut despite strong public opposition – and it was clear that this would have caused enough anger to unite opposition to the project.

Meanwhile I was trying to make plans for my retirement. By this time I was already into my 70s and finding the very long hours Increasingly tiring. All options were on the table as far as i was concerned. At the time when the New Surgery was about to be put under new management without any form of public consultation we put forward a social enterprise plan (rather like the John Lewis model) to give patients more of a say in the running of the practice. As previously stated, this was dismissed out of hand and the New Surgery was handed over to a private company with no connection to or interest in South Woodham. The social enterprise plan was resurrected when we started thinking about handing Greenwood Surgery over to ‘new management’. Would the patients be interested in taking over the running of the practice? The Patients’ Participation Group which had been extremely supportive throughout the difficult years considered this proposal but concluded that it was too much of a responsibility to take. I fully understood this view as running General Practice is not as easy as it sounds.

I also asked the nurses who had always been the backbone of the practice if they would like to take it over. Given their track record I was confident that they would run it in the best interests of the patients – which is not always the case when doctors run a practice. They were also reticent to take on this huge responsibility given the constraints imposed by the practice income.

The problem with the conventional route – handing it over to medics – is that either the funding would have to be drastically improved in order that they would agree to run it in its current form OR, if the funding remained as it was, the standard of service would have to be drastically cut (fewer staff, fewer services etc) in order that they could pay themselves anything like the going rate. By this time the practice income had improved somewhat – to the extent where I was no longer having to subsidise the practice out of my own pocket in order to meet the staff costs – but it was nowhere near enough to attract good quality docs without making drastic cuts.

Nobody in their right mind would work for nothing (or next to nothing) – and my situation was well known if only because I’d changed my name by deed poll to John Cormack The-Family-Doctor-who-worked-for-the-NHS-for-Free. To make matters worse, I’d also recorded a song (GP Blues) to emphasise the point!

One possible way forward would have been for the town’s practices to have joined forces so they would have more clout. The independent practices in the town (in other words the practices that weren’t run by the PCT) had worked quite well together, joining forces to campaign on specific matters. To have some sort of financial tie, though, would stretch this collaboration to a much higher level. On the plus side, we could have campaigned more effectively to have some of the funds that had been removed from the town when the two town centre practices were closed (because it was cheaper to incorporate them into the remaining practices) restored to the SWF healthcare budget. The downside, though, was that Greenwood Surgery would have been a drain on the other practices resources if we hadn’t succeeded in increasing the reimbursement because our ‘budget’ was so much lower than the other practices. And, even if we had successfully campaigned for better funding, the fact that I was retiring and new GPs who were unknown factors as far as the other practice were concerned would be coming in made for an uncertain future for those practices. In the end the downside triumphed and I was left with the only remaining option – that being to use the conventional route i.e. retiring and handing over the practice to a doctor or doctors.

So much for the tedious aspects of general practice. What made it worthwhile, of course, were the patients – particularly those who we’d known for decades and had became friends. And when the time came for them to ‘shuffle off this mortal coil’ we were happy to look after them at home. The care they got from relatives was invariably second to none – but it’s often the case that those who do most for their relatives are the ones who feel most guilty when they’ve gone. “If only I’d done this, that and the other for them. If only … if only … if only!” For this reason I usually sent them a little note after the event to confirm that I was genuinely VERY impressed by the way they’d dealt with the situation. The only example I can find of such a letter is from the leaflet celebrating the life of Ron Cutting, a delightful old chap who invariably brightened my day. My letter starts at the bottom of page thirteen. I’m sure the family won’t mind me sharing it with you as they all inherited his ‘niceness gene.’ And if anyone wants a guide on how to put together a fitting tribute to a much loved relative, you’ll struggle to do better than this family’s masterpiece!

Dr. John Cormack