Frustration with TLAs and bureaucrats

By | 1st July 2010

Dr WhoLets face facts I’m a pretty modest chap.

In fact I doubt if there’s a more modest chap on the planet. I’m not one to sing my own praises or even blow my own trumpet but I do consider myself to be a pretty ok GP. And I’m the first to acknowledge that being pretty ok is quite an achievement.

There are few jobs on the planet that managing to do the job ok is such a success. Society views being average as rather a bad thing – if your performance is below average then quite obviously you need to improve – but, by definition, half of all GPs will be below average!

Victor Meldrew

The great challenge of General Practice is its vast width, apart from covering the whole of medicine it is also firmly entrenched in social care and psychology as well. If the job were to be broken down into component parts it would be numbered in thousands, possibly tens of thousands. Which explains why I’ve spent the last 30mins in a pretty permanent Victor Meldrew stew, wandering around the surgery muttering away to myself.

Well it partly explains my mood, the missing bit of the equation is a couple of TLAs (three letter acronyms) namely PCT and CQC. The PCT has asked me to complete a 17 page document to ensure that I am competent at performing minor operations. Having been a GP for 20+ years I must have performed well over a thousand such minor operations without any fatalities or indeed any problems apart from the odd minor complication such as a wound infection.

Nonetheless I now have to spent a lot of time each month providing the PCT with data and audit regarding my minor operating. If this were the end of the bureaucracy then I might simply accept it – but it is far from the end. We now have to follow guidance on a myriad of minor things from hand washing to blood letting. Each document requires a lot of work without any patient benefit. Hand washing in hospitals is an important tool in fighting the spread of disease, hand washing in primary care does not save lives.


And herein lies the problem there are a number of guidelines which should be followed by hospitals and specialists but should not be transferred over to primary care but it will not save lives but will tie up scant resources in practice.

If the bureaucrats get their way I will spent all my time going on training courses, reading guidelines and producing audits – patients will become an unimportant distraction in this bureaucratic nirvana! I live in hope that this new government will see sense and accept that life is not risk free and start to cull guidelines and bureaucrats.

I have a sneaking suspicion that I may just have inadvertently caused offence to civil servants, I do hope that they’re not protected by our discrimination laws!

Leave a Reply