1.
A Case of Supply and
Demand - Graeme Wilcox |
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In the
In the previously cosseted surroundings of our quiet little backwater events have been passing us by and our colleagues in IN many parts of the country have made, or are making, increasing use of alternative systems including deputising services, extended rotas, primary care emergency services etc. It is surely becoming more and more obvious to us all that we also must make changes - not only for the sake of our personal well-being and sanity but also for the sake of general practice in this area in the future. General Practice is once again becoming the Cinderella of medical careers where new graduates are less and less inclined to invest their futures in a business where they will be dragged unnecessarily out of bed more and more frequently - instead they will invest in a career which will offer him a regular good night's sleep and a fresh mind to face the challenges of the following day.
Moves are recently afoot locally to consider changing our out-of-hours responsibility in such a way as to relieve the burden on general practice and at the same time support our local A&E department which is experiencing serious staffing problems. Unless these moves are given some credence there are serious doubts about the viability of the A&E department, and if it did close, it does not take much time to realise where the burden of its workload would fall.
We sincerely hope that local general practitioners will enter into meaningful discussions on this very important matter and face the problem head on to try and ensure our own peace of mind as well as a service to our patients which we can be proud of.
Graeme Wilcox
FROM
KIDDERMINSTER TO
On April 1st
1970 I was appointed Consultant Physician to
Shortly after
arrival, I was press-ganged by John Ball, Bob Gibbins, John Sheward and others
to become Post Graduate clinical tutor - which I was delighted to accept,
particularly as one of the country's earliest postgraduate centres had just been
built after sterling work in fund - raising by the above and others. With the
support of one part-time secretary we began an educational programme which I'm
sure has since expanded out of all recognition. After a visit to
By this time
I had been joined in
After a
fascinating year in
Our two
daughters flourished and I'm sure our retirement will be greatly enriched by
seeing more of them and of our two granddaughters. We still feel a great warmth
for
John Peaston
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On Wednesday 15th February, at the Post Graduate Centre, some 100 members and guests were given a superb illustrated lecture by Dr. Mike Stroud.
Dr. Stroud, a
well known explorer of the polar regions of the earth gave us an introduction by
way of a description of earlier expeditions to the
After a superbly illustrated description of his trip, he finally gave a short description of the results of research performed during the journey. The lecture was followed by a buffet supper prepared by Angela McCarthy.
We were
delighted to welcome Phyllis Oxberrow and her husband who were on holiday in the
At a meeting of the General Practitioners Association on Monday 13th March the question of G. P. out- of-hours cover was discussed. A decision was made to form an investigative committee (chaired by Graeme Wilcox & secretary Barrie Davies) to look at all the alternatives including linking in with the Casualty Department.
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The
Northumberland House Practice is not among the longer established practices in
Kidderminster
, but its story is nevertheless an interesting picture of
change. Sadly, the sudden death of a single handed doctor can simply erase a
chapter of history, and so it was when Dr. Mildred Latham died in the late
Summer of 1957. However, we do know that she succeeded one William H. Jervis (MD
Lausanne 1930) who came to
A practice vacancy of 1500 patients was advertised, and John Ball, then a trainee with Donald Black in Stourport, was the successful applicant. He started in November 1957 and became one of the 5 single handed doctors in the town at that time. In the event, the actual list size proved to be only.900 souls and the first year profits were £1128 so the influenza epidemic that Winter was something of an economic bonus!
By offering a
comprehensive range of services, maintaining its hospital links, and with Pam as
an assistant the practice gradually grew in size and activity (baby clinic
attendances totalled 88 in 1958). In 1960 it became possible to move to
converted premises on the opposite corner at
John Ball
(John Ball went from the founder chairman of the Kidderminster & District GPA in 1965 to chairing the GMSC in 1980 and then the MPC until this year. He is now serving on the GMC. John was voted an honorary member of the Society at this year's Annual General Meeting)
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PATIENTS
CHARTER 1938
(? Doctor's Charter 1995?)
NOTICE
The committee require an insured person on receipt of medical benefit to comply with the following rules as to conduct :-
(a) He shall,
when applying to a practitioner for treatment, produce his medical card, if
required by the practitioner to do so.
(b) He shall obey the instructions of the practitioner attending him.
(c) He shall not conduct himself in a manner which is likely to retard his
recovery.
(d) He shall not make unreasonable demands upon the professional services of the
practitioner attending him.
(e) He shall, whenever his condition permits, attend at the surgery or place of
residence of the practitioner attending him on such days and at such hours as
may be appointed by the practitioner.
(f) He shall not summon the practitioner to visit him between the hours of 6pm
and 8am except in cases of serious emergency.
(g) He shall, when his condition requires a home visit, give notice' to the
practitioner, if the circumstances of the case permit, before 10am on the day on
which the visit is required.
The rules of the committee also provide that any complaint by an insured person which is adjudged by them to be frivolous or vexatious, shall be regarded as a breach of their rules. Any insured person who is guilty of a breach of any of the committee's rules is liable to a fine not exceeding 10/0d, or in the case of repeated breaches, 20/0d or to be suspended from Medical Benefit for a period not exceeding 1 year. These rules are liable to alteration, due notice of which will be given in the public press.
Taken from a medical card issued in 1938 and kindly sent to the editor by Tim Wadsworth.
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I joined the
York Street Practice in 1951 as a trainee assistant after National Service and
15 months obstetrics in
The hours worked then were quite ridiculous - a hangover from the war years I suppose. I had half days on Tuesdays and alternate Sundays from 1 pm to midnight and so I was in effect working an average of over 150 hours per week. I had 2 weeks holiday a year. We had 2 receptionists working alternate shifts of 8am to 2pm and 2pm to 8pm. There are approximately 30 on the practice payroll today!
During the
60s John Bywater and Charles Mackie joined us and in the 70s, Peter Batty and
Tim Chew. Just before I retired in December 1987, Lesley Hickman joined the
practice. When I started, Dr. MacArthur owned York House and the adjoining
practice premises. His surgery was in his sitting room. Three surgeries, a small
dispensary and a waiting room were tacked onto the end of it. When he left York
House to live in
We were fortunate in having for most of my time the services of Lorna Kimberlee who worked as receptionist, dispenser, secretary and practice manager from 1948 to 1982. She was a founder member of the Association of Medical Secretaries. Chris Jenkins was a very able successor. Despite what was always a very heavy workload, especially at first, I enjoyed my life in General Practice, but in the last few years I was becoming somewhat disillusioned by the increasing administration, computerisation and threat of litigation. When the time came to go, I had no regrets.
Tom Mackie
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I was recently in contact with the FHSA over the out-ot-hours contentious issue. In reply to my letter I received the following (paraphrased) letter from Elspeth Metcalf, the FHSA Chairman, which I felt would be of interest to all local GPs.
'I am deeply concerned at the pressure felt by our excellent tamily doctors in this county, not only with all the extra day time activities now carried out in general practice but also with the pressures in out-ot-hours work. As you know, we are 100% committed to supporting our practitioners in any way that we can to make practice life more efficient and more effective in the interests of both doctors and their patients. To this end, we are in discussions with GPs in a number ot towns in tbe county about ways in which the out-of-hours service can be more efficiently organised so that fewer doctors are on duty at night and that the out-of-hours links in effectively with either community hospital services or even A&E departments if this is appropriate. The very successful out-of-hours pilot scheme based on the community hospital at Evesham is proving very acceptable both to patients and GPs in that area and I will ask John Gregory to get in touch with you to discuss whether practices in Kidderminster would be interested in developing a scheme that might be appropriate to the Kidderminster practices which have a long record of working together.’
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