hoolet Issue 50 - Winter 2006

Chris Johnstone Intro
Hamish MacLaren's Pilchard
In Need of TLC
General Practice in 2025
Blindness
EIFF 2006
The Truth About Donaldson
On Being a Man
A Letter By Jove
A Fairy Story
The BJGP 13 Years from now

Now We Are 50

By Chris Johnstone
Contact the editor by e-mail at christopher.johnstone@ntlworld.com

So here it is, Merry Christmas, hoolet is 50 issues old. Our golden anniversary and we do not look look a day over 45. When we first started Rocket, it was 1990 and my eldest was just a babe in arms. Thirteen years ago the first hoolet soiled your doormats and now my eldest is doing the covers and treats me like a baby. 1993 seems so long ago, a different country. John Major was clinging to power with more enemies in his own cabinet than across the floor of the house and Tony Blair was still cherubic and full of infectious hope. Limited devolution was still a pipe dream and the concept of a Scottish Parliament, let alone a spectacular one, too ephemeral to even consider.

But time passes, with increasing speed, and look where we are. Tony's burnish is more than tarnished and we are enjoying the guilty pleasures of making our own mistakes. Our parliament is spectacular, hang the cost, and we have a fair system of representation. We have had a joint government which has led the way in social change and we have the fairest socialist policies in the kingdom. We run our own health service and we are looking to separate further. Furthermore the English are happy to let us go, but Westminster cannot let go .

We also have another new contract, less than three years old and already those with short memories are saying they would not vote for it again. You may feel unhappy with the contract, but it has done a lot of good. It has focussed a lot of time on good evidence-based medicine and should prevent or delay hundreds of thousands of strokes, M.I.s, renal transplants, heart failures and deaths. It has transformed my working life and family life and I am now earning a more decent wage for the considerable effort I put in. The contract is not perfect but with time it could be allowed to be even better.

Our current problem is not with the contract however but with the government. They are reneging on the deal they shook on. Once we had signed the new contract we could not go back and they can now concentrate on writing the contract they would have liked us to sign.They give us a pay cut, more work for less money, poor pension deal and we cannot say a word as they publicly berate us for being greedy and caring more about money than patients.

I supported the contract when it first came out, but I did say that if you wanted to sell off practices to private companies, you first had to make practices commercially attractive and that is exactly what the new contract did. In no time at all the English health service began doing just that, 4% of English practices are already run by private companies.

Our lovely NHS in Scotland has until recently resisted Gordon's pressure to follow the English example. The first Independent Sector Treatment Centre in Scotland is a signed and sealed deal at Stracathro, just as the London parliament gives ISTCs a big thumbs down. More frighteningly the first Scottish practice has put put up for public tender and Serco is one of the bidders for it. I do not remember voting for privatising the NHS when we elected our first Scottish parliament since 1707.

So the last thirteen years and have been times of increasing change and excitement. We have gone from a golden age for general practice to a time when we seem to be achieving more than ever before, but appear beleaguered on every side. Maybe it has always been so, I do remember moaning about everything back then, but I don't remember worrying so much about the future of general practice. Our lot was good and it seemed nothing could stop general practice continuing forever in a golden glow.

But the next thirteen years do look quite so safe and cosy. Innovations to undermine, sideline and destabilise general practice are on all sides. We have private companies knocking at our door, nurses are becoming more independent and claiming that they can do most of our job, physician assistants are been flown in to do all that we can for half the price and pharmacists now have lists, which once belonged to us. And the government does not like us.

We have one main support that none of the others do and that is our patients. Working for them and with them over the years has built a bond that cannot be easily broken.

So I look forward to another thirteen years doing what I enjoy best; treating patients, sharing their ups and downs and helping them when they need us most. And I look forward to them making my job the best in the world.

I would like to thank all the people over the past thirteen years who have helped to make hoolet what it is, there are too many to thank individually, but they include Alec Logan, Mac Da Souza, Niall Cameron, Louise Hallam, Rob Hendry, Mairi Scott, Ruth Wallace and many more. All our contributors deserve a special mention and our thoughts go to Ali Bodie, who I hope will write for us again next issue.

Merry Christmas and a Happy New Year to all our readers.

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