Timber.r.r.r.r.r.r.r.r

Everybody and his or her dog reckons they know how GPs work. They don't need to ask us before providing new systems 'cos they already know what we do. They don't need to ask us if the new system will work. Of course it will work. Could anything be more simple? Well let's see.

The "Choose & Book" system had a cleverly designed form that it printed for us to give to patients. It provided them with their reference number, the information they need to contact the hospital of their choice and finally their password. The minimum amount of information requires about eleven inches of text. For those of us in the world of "A4" that's one sheet of paper for the first nine inches of text plus one sheet of paper for the remain two inches. There's lots of white spaces so it could have been condensed with a just molecule or two of design. Now after five hundred referrals and five hundred sheets of (almost) blank paper, we were delighted? to see that they have redesigned the form. Some bright spark at CfH has discovered Text Boxes. Yippeee.

Now two sheets of paper have become three. The second has a little bit of writing. The third has a couple of lines or so.

Timberrrrrrrrrrrrrrr.

Wow! What a response!!

Patsy,

The speed of your response is breathtaking. Thank you.

Thank you for the names I requested as examples of very bestest practice. I'm ashamed to admit that I thought you might find it a little difficult to find a name but so many?? That's truly impressive stuff. I've already had a preliminary chat with most of them and will update you further once I 've had the chance to absorb the 28-carat nuggets that were forthcoming. However, these are my first impressions:

John Prescott was really helpful (I think). It was a little difficult to find him at first. I wasn't sure which car he was in and to which of his government-provided houses he was being driven but I am nothing if not persistent and, like the mounties, got my man. He had much to say. I must confess that I did lose the thread occasionally but this is only to be expected when dealing with a man who runs much of the country when TB is away (which seems to be rather a lot these days). (Off the record, he really is worth more than the £150,000 a year plus expenses plus cars plus offices plus staff plus pension etc. A bargain if you ask me). Lord Prescott will only add lustre to the upper house (should he need a third).

Next came John Reid. I really struck gold here since he was able to arrange a "four-way" teleconference between the two of us AND Charles Clarke and David Blunkett. This I was able to get the collective wisdom of all the players who had delivered a Home Office which frankly is an example to us all. It also completely clarified what is meant by "fitness for purpose". Gosh, don't we have a long way to go?

Perhaps the most difficult interview was with Frank Dobson who as your predecessor in 1997 can take all the credit for demolishing those appalling Tory gimmicks such as internal markets, devolved budgets, etc etc. It is still a puzzle to see why he came a bad third to Ken Livingstone and Steve Norris in the London mayoral elections. Clearly it has left its mark. Still he did have some words of praise for the Treasury who have always been so supportive of his efforts.

I've left a message for Ruth Kelly at Education but she's not taking calls. I don't have a number for Margaret Hodge so all-in-all Education is a proving a tad tricky.

Steven Byers suggested floating our surgery on the stock market and then cancelling the shares but was a little vague on detail. David Miliband at Defra suggested I could learn a thing or two about making every penny count by looking at his department's work on the common agricultural policy.

I've left the best until last. Our beloved London Mayor was unsparing in his help and was generous in providing me with a text-book study on spending £800+ millions that wasn't in his budget on buses that now run every ten seconds in packs of five meanwhile taxing the overpaid bourgeoisie swanning around London in their 4x4 tanks to pay for it. Surely there is no better example on how to soak those rich GP bastards. You can rely on Ken.

I am so totally energised by your timely response. You have only increased my determination to prove that we in the health service can do just as well as our beloved leader has done for the people of Iraq.

What a team! What results! What an example to us all.

Your greatest fan

p.s. my thanks to my good friend Dick for his input.

A Letter to my MP

Dear Dianne Abbott,

After much consideration, I have decided that it really is about time that you, as my MP, put my interests at the forefront of your thinking. Gone are the days when every four years or so, you could break off from your busy schedule of evening television programmes to remind us all just how great you have been at doing whatever it is that you do. I think it's about time that you put us, your constituents, at the heart of your thinking.

Recently, I got together a group of citizens and we held a "Citizens Summit" at 'The Fox Reformed' on Stoke Newington Church Street. I asked them what they would like to see from you, their MP. Their responses were interesting and I have sifted through them to find those that are neither physically impossible nor morally repugnant. There were a few left.

First of all, we want to see you at a time and place that is convenient to us. I work away from Hackney so I expect you will make reciprocal arrangements with your Newham colleague so I can visit him during my lunch hour. Also, I'm taking the mother-in-law to Prestatyn in the new year, so I would be grateful for contact details of your colleague there just in case I feel like an evening chat.

Now your website doesn't actually give details of your constituency "surgeries" (I think that's the term) but I do have a number of irritating minor ailments, so I need to know where I can make several appointments stretching through Christmas and the New year. At the same time, I wish to be reassured that should I have a short-term crisis with my brown recycling bin, you will be on hand to get things done. Now I just thought I should warn you that I may, or may not keep these appointments.

When I do visit you, it may be that I will need to speak to someone else as well. I would like you immediately to make me an appointment with that person, again at a time and on a date of my choice. Of course, I would expect you to confirm it in writing.

Finally, I am enclosing my proposals for "Payment by Results". This exciting and radical plan represents the biggest shake up in parliamentary procedure since Dennis Skinner said something constructive and no more that mildly offensive. Quite simply, MPs will be reimbursed on the basis of "outcomes" rather than at present. I suggest fifty five quid for a consultation; twenty pounds for writing a letter; let's say thirty quid for each day in excess of fifty days a year that you actually turn up at Westminster and say something .. ( I was about to say "useful" but let's not run before we walk).

Even more exciting will be the Enhanced Payments to which you will be entitled once we have completed a survey of your constituents. We will mail a number of them at random and ask them questions about what they think of you and your effectiveness as their democratic champion. I attach a sample questionnaire but suggest that you pay it little heed. It's not the one we will actually send out to people.

Finally let me offer you some soothing words about those dreadful rumours that have been circulating. Of course at this stage, nothing can be ruled out but I am happy to reiterate that at this moment in time we have no plans to introduce private contractors into the House of Commons to take over constituencies where performance may be below par. That doesn't mean to say that we won't be pushing to expand those parliamentary walk in centres. You know the ones. You turn up; they listen attentively; and then they tell you that you need to see your own MP for that particular problem. Whilst they don't actually add much value, we do think that they sound good and we'll get lots of brownie points from our friends and neighbours.

I look forward to seeing you next Saturday afternoon at about six-ish. I have this nasty rash on my front drive .....