hoolet issue 38
Autumn 2003
Chris Johnstone Intro.
Waking up from the medical matrix...
Letter
Column
Hope
for Palestine?
5
things I wish Id known before becoming a GP
Tales
of a Grandfather
Alastair
Short
Did You
Know?
Supporting practices by helping managers...
Using SPICE to help meet contract criteria
IM&T
Quality
Practice Award
Practice
Accreditation
Representing GP interests
Revalidation -
In brief
New Educational Opportunities, New Tools
Is There Life on Mars?
BLEEP
Embarrassment
hoolets
Top Tips
Finlay and the Contract Summit
hoolet at the Edinburgh International Film Festival
Where Did It All Go Wrong?
By Chris Johnstone
Contact the author by e-mail at christopher.johnstone@ntlworld.com
These are interesting times and we seem to have even more to do
than usual. Our cups truly runneth over. As a glutton for
punishment I attended two seminars on how new laws are to make our
lives even more complicated and full. The first was on employment
law and the second was on the adults with incapacity act, as I said
a glutton for punishment. Both meetings were typified by GPs
holding their heads in their hands and weeping. Both were also
typified by GPs saying that the whole thing was a load of bunkum (I
am being polite here) and saying that they were unworkable and did
our legislators have no idea of how busy we were and how impossible
it would be to implement the stringent requirements of each piece
of law. Despite this there was a quiet resignation at the end of
each session, it did not matter what we felt, we would just have to
get on with it, like everything else thrown at us.
Afterwards, in a hot bath with a stiff gin and tonic I began
wondering how we got into such a mess. The Adults with Incapacity
Act has several parents, but one of them was a genuine need of
carers. Many carers have been excluded from their loved ones care
by professionals correctly applying the rules of confidentiality. I
heard many carers saying that they were not allowed to know what
was happening to their dementing spouses or to be able to influence
their care as they had no legal status. A positive benefit of the
act allows spouses and family to be kept fully up to speed with
their loved ones illness and to help choose the best treatment and
care for them. This was not a legal right prior to the act.
However, somewhere along the path of good intentions the act has
been turned into a huge overly complex, legalistic monster with
major implications for workload in general practice. But it still
provides a huge benefit to many of our caring patients. Hopefully
by the time you have read this some more sensible rules for annual
examinations will have been thrashed out, but do not hold your
breath.
The laws relating to employment are now too numerous to mention
and Europe’s influence has not always been benign. Their impact is
gathering importance as small employers will no longer be exempt in
a few months time. It is the duty of the employer to prove they
have not been discriminatory and this tolls the death knell for our
informal interviewing techniques. All applicants have to be treated
identically and the employer has to be able to prove this at a
tribunal or the plaintiff will be awarded damages. This entails a
huge amount of work and documentation. Even phoning for a reference
is full of pitfalls and you need to have a formal questionnaire for
the referee and you have to apply the same questionnaire equally
for all applicants. Madness I hear you all crying, as did most of
the GPs on the course I went on. Again however the laws are based
on eliminating unfairness and protecting those who we have
unreasonable prejudices against, even those unconscious prejudices
which we all say we do not have. But again good ideas and
intentions have been perverted into a maze of pitfalls and legal
person traps which overcomplicate the simple task of recruiting
practice members. How did we ever get in such a mess?
I blame lawyers. Mind you I blame lawyers for a lot these days.
Lawyers were involved in drawing up the legislation, but more
importantly they are involved with implementing it. They have taken
mainly sensible laws designed to protect and turned them into rods
with which to beat unwitting (and sometimes witting) defendants.
Many cases brought before tribunals and courts may seem petty and
sometimes ludicrous, but as the law is written they may be acted
upon and lawyers are not slow to see how they may take advantage,
on behalf of their client of course.
I blame lawyers. Mind you I blame lawyers for a lot these days.
Lawyers were involved in drawing up the legislation, but more
importantly they are involved with implementing it. They have taken
mainly sensible laws designed to protect and turned them into rods
with which to beat unwitting (and sometimes witting) defendants.
Many cases brought before tribunals and courts may seem petty and
sometimes ludicrous, but as the law is written they may be acted
upon and lawyers are not slow to see how they may take advantage,
on behalf of their client of course.
I should maybe declare an interest in this topic at this point.
I have recently had two irritating episodes which have coloured my
view of lawyers. The first was the perennial problem of having to
attend court, at short notice as usual, but not so short that I had
an excuse not to attend. As usual I was kept waiting outside the
court for over two hours. At least this time the lawyer was good
enough to come and see me after an hour and explain that counsel
was making some arguments to the Sherriff. An hour later I was told
that the Sherriff had decided to postpone the case and the lawyer
would let me know when I would be needed again. I know I am not the
only person who this has happened to, untold hours of professional
and police time is wasted every year because lawyers cannot get
their act together. And no-one seems to do anything about it.
The second instance was receiving a horribly threatening writ
over an incidence which occurred nearly three years ago. I had been
aware of the case, but up until that point I had been led to
believe that only the hospital was being sued. I contacted the
MDDUS within seconds. I was instantly reassured that this is known
as a ‘Triennium Buster’. Apparently if the patient chooses to sue
me they have to have something in writing within three years. I
should not worry. However it would be advisable to send them all
the details and an account of my involvement. Now I have to wait.
If I hear nothing within fifteen years it will be time expired.
I do not have a glib answer for all of this, but I would advise
everyone to be aware of the oceans of law which are already lapping
around our knees. There be monsters.
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