Dr David John Maddams - The Doctor Can’t See You Now: Reflections of a Retiring GP

The Doctor Cant See You Now

First published in 2019 by

Panoma Press Ltd
48 St Vincent Drive, St Albans, Herts, AL1 5SJ, UK
www.panomapress.com

Book layout by Neil Coe.

978-1-784529-04-8

The right of Dr David John Maddams to be identified as the author of this work has been asserted in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988.

A CIP catalogue record for this book is available from the British Library.

All rights reserved. No part of this book may be reproduced in any material form (including photocopying or storing in any medium by electronic means and whether or not transiently or incidentally to some other use of this publication) without the written permission of the copyright holder except in accordance with the provisions of the Copyright, Designs and Patents Act 1988. Applications for the copyright holders written permission to reproduce any part of this publication should be addressed to the publishers.

This book is available online and in bookstores.

Copyright 2019 Dr David John Maddams.

To all my friends at Dolphin House Surgery and NHS staff everywhere you are truly amazing!

Very powerful, honest and raw with humour thrown in. It blew me away.

Angela Spencer, child health author

Very funny, sad and honest all at the same time.

Dr Clare Gerada MBE, past chair of Royal College of GPs

With thanks to my stepdad (my dad for 56 years) who believed in me enough to encourage me to be the first of the family to go to medical school.

Love to my mum, who died at a ripe old age just before publication and would be saying as she often did, I dont know where he came from, which is a bit disconcerting!

Much love to my doctor wife Jane for putting up with me and doing her medical training in geographical reverse to me so we met in the middle. Luton was so romantic!

Love and admiration to my medical kids Jess and Alex who are two of the kindest people I know and will make amazing doctors.

Thanks to Dr Peter Martin GP of Laindon, Essex who showed me as a medical student that GPs were awesome and to his colleague Dr Ranvier Bass for honing my GP skills as a trainee GP.

But mostly, a huge thank you to the people of Ware, Hertfordshire for letting me be their GP and confidant for over 31 years. A remarkable privilege which I will always treasure.

Age 59 and with 35 years of experience of being a doctor, I decided to write down my thoughts and experiences as I started to complete what I envisaged would be my final year as a GP during one of the NHSs most dicult times in its 70-year existence. Things were so bad that NHS staff were leaving in droves and the service was close to breaking point. Many excellent GPs younger than me had already left.

Would I manage to hold on for another year or would I go the way of others before me? As I reminisced about my former years as a doctor all kinds of memories and thoughts came to the surface. Why did things need to change for changes sake anyway as many developments in the year were having a negative impact on family doctors? Were we seeing the end of general practitioners as we have known them? Then there was the problem of was I ready to retire? What would become of me and my patients? Clearly my final year would be far from straightforward and what would be the outcome in the end?

Chapter 3 May/June
Coming of Age and Waistcoats

Chapter 4 July/August
No GPs and My Resignation Proposal

Chapter 7 January/February 2019
Im Sixty, Suicidal Pharmacists and a Suffolk Sunrise

Chapter 8 March 2019
Time To Go, Tears and a Stag Called Steve

My 59th birthday, January 29th 2018, was meant to be the day I would suddenly feel better. After all, the NHS was in free fall and I could easily retire a year from that date aged 60, having been a family doctor for over 30 years and part of the NHS pension fund since 1982. I envisaged ticking off the days one by one saying thats the last time I will ever have to do this on this particular day. It was bound to feel awesome. I would be grinning from ear to ear all day. With all this experience behind me I was a truly fulfilled and complete doctor with just 365 days to go and counting.

Unfortunately, things in life are never as you expect. For a start I was slow off the mark getting my holiday request in and was pipped at the post by two colleagues also wanting that day off. Then I found that if I was to work I would have to be on call as the duty doctor. More misery! Then having had his operation for cardiac surgery delayed, my dad was called with a revised operation date: January 29th!

Oh how I loved the NHS and the winter of 2017/18 when everyone except our government came to the conclusion that the NHS was broken, or if not broken had a severe case of dysentery. Everything that winter seemed to be going down the pan.

Then there was the thought: did I actually want to retire after all? What would I do instead? Since 24 years of age being a doctor had taken up a huge chunk of my life. I could see this year was not going to be as straightforward as I had originally planned. It now felt complicated. I felt ill at ease. The grin had definitely gone.

Hopefully as the year progressed I would come up with an answer. I would feel better about all this, or would I?

Everything in medicine and general practice had suddenly become very complicated that January. With doctors and nurses finding the pressure too great they were actually leaving the NHS in huge numbers. In fact, over three months recently, more than 200 GPs had quit early. A far cry from when I started out and there had been 200 applicants for my GP trainee post. However, the thing that galvanised doctors more than anything during the cruel flu-stricken winter of 2017/18 was the case of Dr Bawa-Garba. Everyone working in medicine was suddenly in shock.

The story goes like this. A junior hospital doctor, returning from her maternity leave and therefore presumably not fully back up to speed, was found guilty of manslaughter when a poor unfortunate boy with Downs syndrome in her care died of septicaemia. Mistakes were made. However, it turns out that hospital IT systems were down so results were not getting back to the medical team in a timely fashion. Dr Bawa-Garba had been reported as covering up to five colleagues due to staff shortages. The most senior doctor supporting her was not at the hospital. She then made the fatal error of not resuscitating the boy thinking he was another patient.

Without doubt, the whole truth about the case needed to be heard and lessons needed to be learnt. Certainly those who failed him needed to be punished appropriately. But what happened next has sent the profession into apoplexy. The General Medical Council overturned the lay tribunal decision to suspend her and instead had her struck off. Thats it, game over. Not being a doctor anymore. Damned by one case. How many had she saved up until then?

So as of this month every doctor or nurse is left wondering what if I make a mistake? People make mistakes in their jobs dont they? What is bad enough to be found guilty of manslaughter and to lose ones medical career where making life and death decisions is a regular daily occurrence? And what now the health service is under serious pressure with lack of resources and lack of staff? Whos to blame now?