Andrew Willis Saighton Books, 2017, PB, 364pp, £12.99, 978-0995655515
Two years after taking early retirement I suffer a recurring nightmare. I have agreed to do some locums, but remember that without GMC registration and MPS membership I cannot work as a doctor. I wake with a start, relieved. I offer to read this book. Why? Willis’s career predated mine by a few years but covered many of the same years, and I seek both the context of an alternative view and, perhaps, some corroboration of my own.
Willis is an optimist, an enthusiast, an apologist. General practice was OK in his world, and getting better. He calls his book a memoir, but the real detail is in organisational history — both nationally and in his own practice. Anecdotes are sparse, personalities vague, conflicts — if any existed — carefully airbrushed out. There are no heartsink patients, partnership wrangles, difficult staff; even politicians receive very faint criticism.
Nevertheless, as I read of the innovations in his practice, I regret not having visited Northampton in 1993, when I was writing a series of articles for the BMJ on Enriching Careers in General Practice. Willis and his partners were quick to see the potential of collecting and organising information, whether in card index systems or computers. They improved their premises, recruited nursing staff to take on the routine tasks of CDM, developed a patient participation group, pioneered locality-based commissioning as an alternative to the fundholding system, and piloted computer networking and electronic prescribing. I am delighted to share his memory of the cooperative pre-1990 NHS, in which — before the government bastardised the word ‘choice’ — GPs were free to refer to any hospital, anywhere. Willis allows a moment of nostalgia for ‘the day of the enthusiastic amateur’, the ‘organised curiosity’ of cottage epidemiology, before his eyes light up in response to the power of universal practice computing in an era ‘when no working GPs will remain who experienced the need to create paper systems themselves’.
- © British Journal of General Practice 2017
