At the turn of the century, the Botox era momentum increased and Hilary‘s husband Mervyn, who had been a GP in Danbury decided to set up an ‘aesthetic clinic’. He wanted Hilary to join him and given that general practice in South Woodham was very hard work with poor remuneration, she agreed. It was a sad day for the surgery because she had been a great GP and we’d put together a good team – and, while it was hard work, we also had a lot of fun. That said, I fully understand young doctors wanting a better work life balance and better remuneration. It wasn’t long before she was earning in a day what she had hitherto earned in a week (while juggling family life with an unsocial hours ‘on call’ commitment). So we set about looking for a replacement GP.
Meanwhile all the other practices in South Woodham carried on doing a good job. These practices had grown up in a haphazard manner because there had been no planning for healthcare in South Woodham – but their random distribution throughout the town actually worked quite well. Most patients (even the elderly) could get to their local practice on foot and, given that the practices were small by today’s standards, they seemed warm and welcoming, and there was pretty good continuity of care. When Dr Ingold retired she was followed at Kingsway’ by Dr Jayant Patel, who had hitherto been a partner at the practice. When he retired the practice took a bit of a dip for time but experienced a renaissance when Dr Susan Mathew took over. At Brickfields Surgery, Drs Suzanne Everett, Anne Dyson and Ramesh Patel proved to be a strong team. They elected to become a ‘fundholding practice’ under Ken Clarke’s ‘new contract’ – for those interested in the minutiae of General Practice, this was a form of ‘commissioning’. The practice subsequently managed to negotiate becoming a ‘PMS practice’ (a new version of the GP contract) when fundholding was done away with … all of which enabled Brickfields to make the best of a bad job when it came to funding. The downside of the PMS contract was that, when it was scrapped with a view to providing a more level playing field, the funding of the practices that had benefitted from it took a nosedive. I know this caused problems at Brickfields Surgery but it proved terminal for a nearby practice. Four GPs at Sutherland Lodge Surgery in Chelmsford resigned, citing a significant cut in NHS funding as the reason they could no longer maintain the current level of service according to BBC News and Practice Index. The funding reduction, part of an NHS England review to make funding more equitable, led to a substantial increase in the doctor-to-patient ratio, from 1:1890 to 1:4000, making it impossible to continue operating at the same standard, according to Pulse Today. The practice, which had served 12,200 patients for 110 years, was forced to terminate its contract after the funding cut of £380,000 over two years. It had been a practice which had been recognised as providing an outstanding service – but the local NHS managers decided to hand it over to a private company. Within a year, this ‘outstanding’ practice had been placed in special measures.
Meanwhile, Dr Praful did sterling work at the Clement’s House Surgery and he took on Dr Gorai as a partner when he started thinking seriously about his retirement … which was sadly cut short by a heart attack.
When Dr Ingold died I was invited to her ‘woodland funeral’ …. which was a very eco-friendly affair. We gathered at the graveside on a gloriously sunny day and waited for the funeral cortege. Eventually, a Transit van pulled up, The rear doors were thrown open, and her cardboard coffin was taken out and laid on two planks which straddled the grave. At this
point the sky darkened and it started to rain very, very heavily. During the funeral service the mourners were transfixed by the coffin as it became increasingly soggy. In my mind’s eye the coffin began to disintegrate and I feared seeing a forerunner of the ‘family funeral scene’ from Alma’s Not Normal … but, fortunately, the service ended in the nick of time and the coffin was lowered reverently into the grave without incident. Sylvia Ingold would have loved every minute of it!
The financial situation at Greenwood surgery had never been good (although it became much worse at the height of the PCT era.) for this reason we tended to take on doctors who had spouses who worked in the area and had a reasonable income – so their families weren’t reliant on what they took home. Hilary was one example – and Donald McGeachy, who followed her, was another. And so the practice entered a new era and, although we knew we’d never find anyone as good as Hilary, all seemed well … at the outset.
Dr John Cormack