Over the last four years I have been a member on the GMC's Fitness to Practice panels - dealing with the disciplining of doctors who have got into difficulties in one way or another. I enjoy the work, and the feedback I had received was that I performed well. However we recently had to undergo an external assessment before being considered for re-appointment by the GMC. There has been a lot of discussion about the appropriateness of this form of assessment, but I was surprised to hear that the verdict on myself was unsatisfactory, and I would need some remedial re-training and then be re-assessed in a year. I was surprised, but it is always difficult receiving criticism. So I have sat through what in fact was a very useful day going over all of the aspects of the panel's work. Here's hoping I can pass the re-assessment this time next year.

So at last we come to the day 40 years later. At that time I was a handsome young doctor, and Jenny a beautiful nurse. We married at Holy Trinity Church in Nailsea after a whirlwind romance, half of which was spent apart whilst I sailed the world on the ss Canberra. They have been an eventful time, and the full story will be told elsewhere. I have to admit that I was indulged this evening in being allowed to give a Powerpoint presentation of all the embarrassing photos of the family over the years. We had a wonderful dinner with all the family in one of the top flats overlooking Blackwall basin in the Fraser apartments. It really was very special and we give thanks once again to God for bringing us together and helping us to stay together. How people remain married without God's help is a mystery to me. We could have parted several times when the going got rough, but God came up trumps each time and we struggled through. Now of course we have grown together and neither of us can imagine what it would be like to live without the other.

This weekend I have attended another seminar organised by CiCP on Whole Person Medicine at the home of Derek Munday in North Wales. This is a beautiful spot and the Munday's provide great hospitality for a house party like this. We also spent a good time looking further into the implications of practicing in a whole person way in everyday practice. One of the important ideas to come out was that of the importance of grandfathers. We often talk about the influence of parents but usually forget the unique role of grandparents. As I now have extensive experience of this role I can also see its importance in relationships generally. Grandparents now have a duty towards the youngest generation. They should have more time to be available to the youngsters, listening to them and teaching them about the important aspects of life. They are a special personal resource for the young and can often say things that the parents can't. They don't have responsibility for discipline and so can offer counsel in a way the young can receive.

My cardioversion has now taken place and I am in sinus rhythm. Some 4 or 5 years ago I was treated for coronary artery insufficiency with an angioplasty and stent insertion. I have been well since then but went into Atrial Fibrillation at the beginning of August. Now I am back to normal but have to take anticoagulants (Warfarin) for the rest of my life. This is yet another bother and restriction, but that seems to be what growing older involves. I hope I can adjust and take it in my stride, keeping a happy countenance as my blessings far outweigh the problems. If you are interested I have put all of me medical details elsewhere on this web site, so they can be accessed if I am taken into hospital unconscious!

There are some places which become a very special part of your life - and Hell Bay is one of them for me. This is one of the most westerly parts of England, situated on Bryher, a small island in the Scillies. In this remote place, with no roads and only a handful of people, is a small hotel, The Hell Bay Hotel which has become a haven of rest and refreshment for Jenny and myself.
In November the sea is wild, the wind fierce and the rain horizontal. However they are frequent respites when you can walk and enjoy the wildness of the place, and there is always the Atlantic roaring in and sending the spray hundreds of feet into the air. This is also a place of ancient history with hundreds of stone age burial chambers and stories of a sunken world (about 12,000 years ago it was joined to Cornwall). When the tide is low you can walk from one island to another - we have walked across to Tresco from Bryher.
The sands are white, the seals friendly and the hotel comfortable with excellent cuisine. It is a little hard to get to (helicopter from Penzance), and it will set you back a few pennies, but it quickly becomes an essential part of your life and you look forward to when you can return. However please don't act on this advice as part of the pleasure is not seeing too many other people there!

In The Times today (Public Agenda page 4) is an interesting comment on the attitude of health care staff. It stresses that we ought to be more content than we are - we earn a decent salary and have a fulfilling job, but to quote some interesting comments -

"Why can't health care staff show more compassion? Why can't doctors stop moaning? Why can't people have longer consultations? Are these issues impossible to resolve or have they become so inconvenient that we have stopped talking about them?  ... these are the words of Kamran Abbasi, editor of the December issue of the Journal of the Royal Society of Medicine.  ....  Aneez Esmail, Professor of General Practice at the University of Manchester, says that everyone would be happier if patients had the right to a minimum 15 minute appointment with their GP - with GPs restricted to seeing 28 patients a day. .. Phil Hadridge, a service user, suggests that health workers bring back compassion by carrying out one extra act of kindness a day."

I agree with all of these sentiments, and they form an important part of the book I am currently writing on the whole person approach to medicine - BUT although the problems are easy to name, the solutions will be very difficult to implement. The problem is on a par with the issue of reducing global warming - yes, we all want it to happen as long as we don't have to pay the price personally! So for example, each GP could very easily reduce the number of patients they see each day, but will patients reduce their demands so they have less consultations each year, or will they pay a lot more (whether directly or through taxes), in order to double the number of doctors in this country? There is no doubt in my mind that if doctors did spend more time dealing with patient's problems (psychological and spiritual as well as physical) then health would increase. But also in my experience it is the patients who are often loathe to cooperate as they will have to make healthier life choices rather than expect the doctor to cure everything for them, and then they will also have to pay more for the privilege. Be careful about putting all the blame onto the doctors, it is just as much the patient's fault, and as yet I have not seen any politician who has the guts to face the problem and begin to implement the necessary policies.

And so another year slips into history. It seems only yesterday that we were worrying about the approaching millennium and whether the world would finally come to an end. We still find ourselves worrying about the end of the world, but now we expect that we humans will be the agents of its destruction rather than an act of God. We are trying to live responsibly (I use we, but I have to confess that the driving force is Jenny, who takes our responsibility to the world we have been given very seriously). What legacy will we leave for our grandchildren? What will they say as they look back on our time and see how our decisions and our life style have affected and changed the world they have to live in?

This has been a good year for us. We have had the usual health worries and increasing difficulty with finding the energy and ability to do all of the things we would like to do each day. And yet as my old granny used to say "I can't grumble - it could be much worse". So we count the many blessings we have, and enjoy each day with our delightful grandchildren and children, who still all live within a short distance of us. I have the challenge of completing the Whole Person work and Jenny has a full life with family, spiritual direction and the life in our local Church. Yes we are blessed. Thank you God - we do believe that the Lord gives, and He can take away. But always things do work out for good - even if it seems to take a long time, and often is not finished in this lifetime.  May 2007 be as fruitful and enjoyable.