Dr Shehadeh v Mr Perrin: Like Don Quixote Mr Perrin is shooting arrows at ghosts……

Like Don Quixote, Mr Perrin is Shooting Arrows at Ghosts.

This debate began with yourthurrock asking me to comment on health checks for people with learning disabilities. I gave a rational response. There followed a response from Mr Woodbridge and a retort from myself. Now Mr Perrin has the fray and has turned it in a pub brawl. I have always enjoyed debates and as the Book of Proverbs says “As iron sharpens iron, so one person sharpens another. “ In other words debates sharpen the mind as a sword can sharpen another.

However, as I wield my intellectual sword with Mr Perrin I do not hear the clank of metal. It seems the debate has descended into a cesspool of insults and personal assaults. Alas, my intellectual sword has crossed something soft and unpleasant. Whatever it is, it is not a sword of steel. It is not rational. So I have decided to meet Mr Perrin on his level, and speak his language. We might get somewhere.

Sadly, despite eighty years on earth, or perhaps some other planet, life has not taught Mr Perrin the basic art of reflection or emotional continence. Emotional froth is the wrong tool for this debate. But using the wrong tool may be the norm for him. He seems to think the stethoscope is a microphone. The stethoscope is a diagnostic tool requiring two listening ears. It is predicated that between those ears there needs to be a rational jelly-like organ called the brain, which is a tool for rational decision making.

It is obvious that Mr Perrin has mastered the alphabet. However, I am not sure whether he has learnt to read. I cannot see in his response any evidence that he perused what I had written. It seems that his emotions have completely distorted my blog. Like Miguel de Cervante’s Don Quixote, he is fighting imaginary enemies, and shooting arrows at ghosts, battling against enemies that do not exist. I have relatives with learning disabilities. Neither I nor other colleagues who do not offer these checks are evil or uncaring. How many services does a GP have to offer to qualify for the Hippocratic oath?! And who is the arbiter of that decision?!

The concept of capacity is lost on Mr Perrin. My practice offers care plans to 200 elderly and vulnerable people. Other practices who offer his vaunted health checks may not offer the care plan service. Are they to be vilified?!Once you reach full capacity, you can only add more services by displacement. If you want one more service in, you will have to sacrifice another. Mr Perrin is behaving like a toddler in a sweet shop, insisting on all sorts of sweets totally unaware of his parents’ inability to comply with his demands. The toddler wants what he wants. If he does not have his way, he screams and throws himself on the floor protesting as if his parents were the most evil in the world.

For the record, my practice has offered these health checks, except the provider we used last year has pulled out this year. It is simply lack of capacity and the difficulty recruiting staff to carry out these checks. GPs are trying to federate in order to increase capacity. But this will not happen overnight. Money has got nothing to do with why I have not provided these checks this year. Nor is it rational to assume that because someone is perceived to earn a lot of money, they should offer services for free or at low cost. GPs are not obliged to offer these checks or to sponsor public health. These checks do not have to be carried out by GPs. The NHS could employ qualified nurses to carry out these screens, just as it employs COPD nurses or diabetic nurses. These checks are not based on a reliable evidence base. These are the rational points that need to be addressed. This is where I expect to meet reasonable people. This is where I expect to hear the clank of swords. As Mr Perrin’s response proves, there is a huge irrational emotional element at work here. Rude irresponsible aggressive criticism of GPs will only exacerbate the problem. A visceral response can only produce a stench reflective of its usual unmentionable content.

Patients have the right to complain about the NHS and certainly about GPs. However, the NHS does not have such a provision for doctors or nurses who are insulted by patients day in day out, certainly not in general practice. I believe time has come to redress the balance, only to save the NHS from the puerile attitude of some members of the public. The problem is the unholy alliance between the public and politicians. Politicians increase provision. In return the public offers popularity. Who pays for this? The NHS, especially general practice. Zeal and emotion need to be tempered by reason. Mr Perrin knows little about the work or life of the average GP. Yet he is willing to pass judgement on a profession he neither understands nor is willing to try to understand. This puerile conduct is surprising in a man of his generation. Unless the afore mentioned unholy alliance is broken, the NHS will have soon killed off its most important servants. As for the public, a man reaps what a man sows. Carry on like an ill disciplined spoilt brat in a sweet shop and exacerbate the GP recruitment crisis. Not only will the NHS not be doing your much desired health checks, but a few other services too. Powodzenia! That is Polish for good luck. Start learning Polish. You will need it soon.

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