hoolet issue 50
Winter 2006
Chris Johnstone Intro
100 Words
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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