The Fortune Practice 3

A story continued..

Alex was waiting nervously for her interview. How many people were being interviewed? What were they going to ask her? Of course, she had to believe she could get the job to do well at interview , but she thought it highly unlikely. Whilst she was waiting, she read Mike Dixon’s letter about the myths of commissioning, the article which a couple of days ago had seemed naïve, patronising and possibly deluded suddenly felt very comforting! She was ushered into the interview room. The panel was the CCG chair, the operating officer and Mavis who used to be a receptionist at Alex’s training practice….well, well , well……

Abi Dark, also salaried GP at the Fortune Practice was at home. Her eldest daughter was off school  unwell , Abi was distracted   doing her appraisal. As usual with Abi, she was doing everything last minute and fudging things a bit. Today was a pain though. She had to migrate her toolkit to  Clarity , make up some PUNS and DENS, get together all her certificates and scan them in as well as somehow prepare for her own interview. Luckily her interview was after the NAPC/NHS Alliance conference, she was looking forward to that. Her daughter looked at her with seething hatred

“ I don’t know why you bothered getting the day off work today…you don’t want to look after me.. why can’t I see a proper doctor anyway?”

Abi didn’t really have the patience to deal with all this and it wasn’t long till they slipped into a blazing row, exactly the same as they always did…

Eventually, her daughter painfully screamed about  how much she missed  her dad, how Abi drove him out as soon as she finished using him when the kids were young. She wished she could live with him and not be dependent on her mum…

Abi screamed “go and live with him then, then see if he pays for you and your sistser  to do ballet and music and extra tuition by trying to sell his paintings on the street”

Abi’s daughter gave up screaming there was no point , it never changed anything….her mum was crazy, her dad wanted to work, but Abi had ruined his career by prioritizing her own

Alex got through the interview stage…next ,the election…all she cared about was that she would get more votes than Abi….

The Health Care and Social Services Bill had at the very least been devisive

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The Fortune Practice 2

A story continued…

Dr. Helen Gould  and Dr.Prakash Mehrotra are the Partners at the Fortune Practice. Helen had set up the practice with her now deceased husband 30 years ago.

No one ever discussed Helen’s longstanding platonic affair with her longstanding practice manager Donald…

Helen and Donald were looking at a property in Morocco on the internet. Things seemed so different form 3 years ago. They had decided then that Helen would take 24 hr retirement in 2012, collect her lump sum and buy somewhere for her and Donald in the future.

Things were good back then, it felt like the NHS had never been stronger, services were abundant and moral was high…Now things felt tense…who knows what would happen to her patients in the new NHS in the hands of the commisioning board and Monitor?

What she really cared about was the four walls of her family practice…her castle that had delivered excellent care and collaborative links for 30 years…

Prakash, the other partner was with his patient Roy.  That last TIA  he had had rendered him blind. Roy sat like a voyeur, in his wheelchair ,  now only  functioning on perception

His only family was in Dubai. No skype for Roy , just a strong locus of control and the support services that he could access…which seemed may be fast dwindling.

20 years of time spanned the conversation the men were about to have.

Roy was an ex civil servant. His last days were coming, he had written his living will and he was fighting to be a person and not a target on register.

Prakash would exempt him therefore

“ Fight em “ said Roy , I don’t believe them, just because the NHS is free doesn’t mean it’s what it was…

I know what we  bled out of your generation to keep the NHS alive. There wouldn’t be an NHS if it wasn’t for docs like you: trained to institutionalise   governance , education and continuity of care. I know, you’ve been looking after me that long, since we were young men. Fight any government for this. Of course they will oppose you, your ethical, moral and professional attitude will win,  because you care for your patients, not your own personal interests

Prakash had fought but the NHS had been destroyed…he pondered on the way forward….

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The Fortune Practice 1

If the late Dr. Sinah, the former GP consortium lead, hadn’t had a fatal MI last month, and if  Alex ( Salaried GP at the Fortune Practice)  hadn’t been angered  by a neighbouring practice deregistering another expensive patient that had ended up on her on call list today and if  partnership was coming up round here any time soon… then perhaps Alex wouldn’t have found herself applying for the job of STAR consortium chair.

( Little did she know that the partners at the Fortune Practice were in a meeting discussing taking 24hr retirement and the best way forward!)

Now the Health Care and Social Services  Bill was passed, how else was she to understand what was going on?.. Better to be on the board and using her energy to do the best she could for her patients. “Round the table” as Clare Gerrada had put it on the Today Programme.

Besides, Abi, her salaried GP colleague was applying; never before had Alex come across a colleague  as self interested. Abi’s application just couldn’t go unopposed.

Alex took a look  at the leaked risk register with her own interests in mind:

“ By dismantling current management structures, GP consortia would go bust”

“ GP leaders were not sufficiently developed”

Foolhardy was her application then and full of risk. But then if there was any way she could help prevent the private sector costing more……she felt more determined and clicked send on her  on line application.

She turned off Emis , closed her NHS net and went to go and meet her boyfriend, Andrew.

Andrew was from America, liked going to bars and using Twitter. Just after they settled with their drinks he checked his I phone; Mello Johnny hadn’t tweeted so much for a while ( possibly in a Guillian- Barre like post activist paralysis. Or maybe considering the  next campaign…)

Sipping their cocktails, the March rain, refreshing the air… Andrew and Alex wondered if Clare Raynor would really do as she’d said on her death bed, and come haunt Lansley.

“Might as well move back to Texas, the way things are here now” said Andrew…”At least it’s hot”

Andrew had missed spending Passover with his family but had enjoyed a sunny Easter with his English nephews and neices.

Meanwhile Roy, a  75-year-old blind housebound diabetic, was sitting in his wheelchair listening to Allegri’s ‘Miserere’, when suddenly he felt a numbness of his face. He seemed to be unable to use his right hand to get to his panic alarm…

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