In 1968, after several years of drifting between countries and jobs, I started one of the best periods in my nursing career when I went to work for Dr Alf in West London.

Dr Alf had been in the same practice nearly forty years  interrupted only by the years he spent as an army MO during the war. He trained at Guy’s in the twenties and then moved to a small hospital in the East End where he took his MRCP and then did his DPH and DCH  before starting work as a GP assistant to the old doctor in West London and eventually buying the practice when the old doctor retired.

The practice covered all levels of society from the wealthy flats around Maida Vale and Little Venice to rooming houses and council flats. We had two surgeries, one near Maida Vale and the other on the council estate. It was a modern estate which had been built after the war when the council finished the job started by the Luftwaffe and cleared the small back to back houses. Many of the old families who had lived in those small houses had been re-housed in the modern flats so they had known him from the days when he was the eager young assistant dashing around on his bicycle and he knew the families. He had delivered many of them!

He never lost his enthusiasm for keeping up to date and attended seminars at Hammersmith every Wednesday on his half day off and spent his summer holidays at BMA conferences.

He was an orthodox Jew so employed a part time assistant to cover Friday evening and Saturday. When I first started we had a Hindu doctor from St Mary’s, then a Catholic registrar from Guy’s and finally a Buddhist from St Thomas’s so we were a very ecumenical bunch!

In 1968 it was still quite unusual for a GP to employ his own nurse, (some employed a nurse/receptionist and others had links with the district nurse), so we made the job up as we went along and it seemed to work well.

I enjoyed getting to know the patients and their families and treating them in a holistic way. We had a good working relationship with the hospital, district nurses, midwives, health visitors etc. The only people we ever had problems with were the bureaucrats at County Hall, but luckily in those days there was minimal interference from government…..maybe that is why it all worked well. 🙂

When I read accounts in the papers or posts from Jobbing Doctor and Midwife Muse I wonder what Dr Alf would have thought of the interference they get now. I think he would have been apoplectic!

I feel quite bemused when I hear politicians burbling about patients choosing their own care. I don’t know which is the “best” care and the “best” consultant. I trust my doctor to know that, it is what he was trained for.

When did we start thinking of health care as a marketable commodity instead of a service? When did doctors buy care from the hospital? If Dr Alf decided to send a patient to hospital the consultant saw them, I don’t remember the hospital sending a bill for it. They trusted him to use his judgement. Of course,as in all professions, there were some rogue GPs who were either too idle or ignorant who abused this trust and pushed cases onto the hospital which they could have dealt with themselves, but they were in the minority. We had one on the same road as us who Dr Alf referred to, rather scathingly, as “the clerk of works” because he rarely moved from his desk, just signed prescriptions and certificates and sent anything slightly complicated to the hospital. He worked the basic surgery hours, did few home visits and no night calls. But he was the exception.

We did all minor surgery, ante natals, post natals, infant welfare, diet clinics and routine visits to the elderly and infirm etc. etc. and the patients loved him, even when he yelled at them!

It was a very satisfying job and I learned a lot from Dr Alf. I was sad to leave after six happy years, but I had married JW and we were moving back to Nottingham, so I had to bid a fond farewell to my “London Dad”, as he styled himself.

 I think he would have been horrified at these new reforms, would have been scathing about a health secretary who has only ever been a civil servant and politician (he had a degree in politics!) He has only ever been in politics and yet David Cameron says there is no one in the House who knows more about the NHS than Andrew Lansley. Are there no doctors and nurses in the House this time?

They say that private compnies can give a better service than the NHS. I seem to remember they said this in the eighties when they put cleaning out to private companies and we ended up with poor cleaning and cross infections because the private companies paid minimal wages and put fewer cleaners on the wards. It stands to reason that they want to cream off dividends for their shareholders. I may be cynical but has the fact that Lansley used, allegedly, to be funded by John Nash (head of Care UK and Sovereign Capital, which owns private health care companies)  anything to do with his convictions?

I am so glad that I worked in general practice then, I would be very fearful now wondering what the bureaucrats were going to interfere with next!

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