This section involves NHS bureaucracy and local politics. As such it is somewhat tedious – so speed read it if you value your sanity.

I had started from a very weak position but, as mentioned previously, the local MP at that time (Mark Francois) was extremely helpful. He was newly elected and had yet to be ground down by the system – so he worked tirelessly to ensure that the NHS mantra (Patient Choice) was taken seriously by a PCT determined to ignore it. Needless to say, this made him unpopular with those in charge.

With his help and the overwhelming support of patients the wheels started turning To get approval for Greenwood Surgery to be ‘readmitted’ to the NHS, the Local Medical Committee (or ‘LMC’ – a body representing the views of GPs in the area) first had to give it the thumbs up. I was informed by a doctor from a practice in Maylandsea (Dr Montague-Brown) who was a member of the LMC that that the GP from the other practice in Marylandsea was enthusiastically contacting fellow members to ask them to vote against the ‘reinstatement’ of Greenwood Surgery.

I should explain that, as well as Dr McGeachy, there were two other doctors with strong connections to the PCT who gave the impression of taking a particular interest in this case – one from Maylandsea and one from Tillingham. Together they were rather unkindly referred to by the staff as the ‘three little pigs’. This was partly due to their rotundity … and, even more unfairly, because of the (vague and poorly founded) feeling that they had their snouts in the PCT trough. This rumour was sparked by the very occasional example of situations which could have been handled better. One example – the Maylandsea doctor’s son was paid the sum of £2500 to set up a computerised booking system for Dr McGeachy’s minor surgery clinic. There was no competitive tender process – as one would expect in a situation that could be construed by those less charitable than ourselves as a ‘Jobs for the boys’ situation. From memory this clinic dealt with about four or five patients a week and didn’t last very long. Given the small numbers involved, I got the impression that a cheap diary would have done the job just as well.

Despite the attempts of the aforementioned GP to bring about a ‘No’ vote, the LMC voted in favour of the plan.

This put the ball firmly back in the PCT’s court. There was a meeting held to make a decision. The Maylandsea GP who had canvassed the LMC voted against ‘reinstating’ Greenwood Surgery – but the third member of the triumvirate (the Tillingham GP), who had seemingly behaved with propriety throughout, declared an interest and abstained (for which I was grateful).

Accordingly, we put out a cautious announcement – not wanting to rock the boat at this delicate juncture.

There was a sting in the tail, however. The PCT had come up with a ‘cunning plan.’ The practice finances were constructed in a way that pretty much guaranteed that it would go bust. Steps were taken to create a smokescreen but the objective was clear.

I asked the LMC Chief Executive for advice and he told me that this was a Catch 22 situation. If I said at the outset that it was obvious that nobody could run a practice on this financial package, the PCT would use this as an excuse to say: “That’s the offer. Take it or leave it.” On the other hand, if I agreed to go ahead on this basis, I’d be given a poisoned chalice. I decided to go ahead safe in the knowledge that no ethical organisation charged with looking after the health and wellbeing of patients could allow a state of affairs whereby a group of patients were being actively discriminated against to continue indefinitely. How wrong can you be?

Dr John Cormack