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 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.

Other hoolet online articles by Chris Johnstone can be found at:
hoolet edition 51 - Enough And No More
hoolet edition 50 - Now We Are 50
hoolet edition 49 - The Policy Palsy
hoolet edition 48 - The Last Waltz
hoolet edition 47 - The Old New Contract
hoolet edition 46 - Teaching to the Converted
hoolet edition 45 - Turkeys Voting For Christmas
hoolet edition 44 - That's a nasty QOF
hoolet edition 43 - Calm Down, Calm Down, It's only the NHS
hoolet edition 42 - Perpetually Fooled Initiative
hoolet edition 41 - Crisis? What Crisis?
hoolet edition 40 - Doing What You Are Told
hoolet edition 39 - A History of hoolets
hoolet edition 38 - Where did it all go wrong?
hoolet edition 37 - Commodificationalising the NHS
hoolet edition 36 - The Cost of Everything and the Value of Nothing
hoolet edition 35 - Much Too Much, Much Too Soon
hoolet edition 34 - What Shall It Profit a Government?
hoolet edition 33 - A Long Career in Applied Cynicism
hoolet edition 32 - My Greatest Pleasure
hoolet edition 31 - Goodbye to the NHS
hoolet edition 30 - The National Health Service is Sorry
hoolet edition 29 - MMR More Media Rubbish
hoolet edition 28 - A Life of Pleasure
hoolet edition 27 - Barricade medicine

Other hoolet reviews by Chris Johnstone:
Bad Medicine
Armed Madhouse
The Bullet Trick
The Medical Detective
Plundering the Public Sector

hoolet is the magazine of RCGP Scotland. It is supported intellectually, financially and emotionally by RCGP Scotland.

This issue maintained by Robert Hallam.