Yes I am just being a pedant

Our Primary Care Trust has, as one of its objectives, "that the health of its residents is as good as other Londoners by 2020". As things stand at the moment, this is near nigh bloody impossible.

For well over half of the patients who register with us, we are their first general practice in the United Kingdom. They come from all over the globe and mostly from areas where their "health" is nowhere near as good as other Londoners: high rates of Diabetes and Hepatitis B from Eastern Europe; Maghreb Arabs seem to have more than their fair share of severe mental illness; refugees and asylum seekers possessing the physiological legacy and mental scars of hardship, abuse and deprivation. We will do our best to care for them all but, for some, good health has receded out of reach for ever.

The high-sounding objective may play well to the gallery but I really dislike it. My PCT tells me that objectives must have a reasonable chance of being achieved. The only way to overcome the arithmetic impossibility of this one is to imitate Dame Porter's style when she ran Kensington & Chelsea: import good health and ban immigrants. No? I don't think so either!

The best we can strive for is to ensure that we have provided excellent primary medical care to all our patients, irrespective of how well or not they are when they arrive on our list. We should all meet a defined high minimum standard of service that would provide the right care to people irrespective of their circumstances. We can then be confident we have done all that is reasonable for our patients even if the outcomes don't reach an irrelevant point on a meaningless graph.