T’was the week before Christmas and in GP Land not a creature was stirring . . .

At present it is a winter wonderland in Northernshire if you are aged seven and a half. Schools have shut early, there is snow on the ground and beautiful clear sunny days for sledging and snowmen (sorry person) building activities and a warm house at night to come home to and dream of Christmas presents to come.

Unfortunately in Northernshire general practice this seven and a half years olds’ paradise is now a land of nightmares as the great British public rushes out to spend millions at shopping malls and online while at the same time expecting UK GP plc to do the same as the shops but for free gratis and nothing.

Spend more and we will produce and sell you more but in the NHS it is a case of demand more and there is no extra cash or goods and we will struggle to cope. So let us look at a few trends in Northernshire GP land these past few days.

Demand has gone ballistic.

At Christmas inter family relationships become more fraught than those current on the Korean border and so grandparents, parents and children all HAVE to be well for Christmas to avoid the Armageddon nightmare meltdown over the festive period of someone actually being ill for there is absolutely no healthcare available at Christmas in the UK. None whatsoever.

Trust us we are doctors and our patients tell us this. So two holiday periods of 4 days and 3 days is a life threatening emergency.

If illness happens it will RUIN ALL of our Christmas so see us all NOW. Any excuse for an argument in a dysfunctional family at Christmas but illness is always a great get out of jail free card for it is never your fault and you can always blame it on the GP.

So conditions that have smouldered away for years are now being presented as life threatening emergencies because they all HAVE to be BETTER by Christmas.

Our reception staff are not enjoying this for when they finish work they have to battle the same loving, generous punters in the shops for they too need to eat as well as have healthcare but our staff are not as yet on holiday.

We have seen the need for “emergency” appointments for:

“I have to be better for Christmas . . .”
(no chance tough luck)

or

“I would like something just in case”
(no can do because just in case ain’t a treatable illness)

or

“I don’t think I could manage to work”
(yes we know you have had a week off already and with the extended holiday there is no point giving you a note for less than 2 weeks for we will be closed so the work shy always win this one, unfortunately).

or

“I need this and this for my holiday (good luck at the airports) and although I have paid thousands for this I would like these drugs for you have to pay £100 to see a doctor abroad (really? Healthcare actually costs something but your holiday is free?). Can I have them just in case?"
(see above).

or

“Merry Christmas and hi y'all we are from overseas staying with our relatives for Christmas and happen to have left all of medication at home and hear that if we claim that we are emergencies you will see us for free and if you are dumb enough to treat us on the NHS then we can get several hundred pounds of drugs for a few pounds of prescription charges?”
(Words like something and die follow and a bit of detective work means someone with the above story and no reciprocal health arrangement gets a Christmas present, together with the words Merry Christmas with true sincerity as they did onto us, they did not anticipate. We love health tourists especially at Christmas).

Clearly we in GP happy Christmas holiday land have not anticipated the complete absence of pharmaceutical products for a couple of weeks for many mornings this week we have had as many requests for repeat prescriptions in 2 hours as we would have in 2 days and all of them have to be ready 5 minutes after they are requested so as not to interrupt Christmas shopping.

A Government desperate to offload anti flu drugs and vaccines before their use by dates may possibly be using the media to generate demand for these products for our midwifes are being inundated with calls from pregnant women for advice re swine flu.

Nurseries too have been printing off NHS Choices leaflets (always a reliable source of disinformation) and suggesting that any snotty nose kid has swine flu as virology we understand is a 3 year degree course for all nursery nurses and so add to the end of the day emergency surge of kids collected from nurseries.

Home visits also increase as every Granny wants to be well for Christmas and the usual story is we brought (ill) Granny 700 miles down from John O’Groats to Northernshire and she suddenly became unwell is about as convincing as the Vatican is a large country 26,000 miles across whose GDP is 4 million times that of the USA and China combined and it is the world’s largest oil producer.

(If Granny needs a home visit under these circumstances Granny needs to be in hospital and that will bugger the family’s Christmas up no end as hospital visiting does not coincide with Christmas Top of the Pops so there).

Granny dumping becomes endemic at this time of year and there are lots of concerned phone calls from relatives, care workers and social services all wanting visits just in case. A home visit grants such informants instant absolution from any duty of care over the festive period for they have rung the doctor especially if it results in a dump and run social admission to a hospital.

(You will get a visit but if it ain’t medical the ball bounces straight back to you).

The great thing about a health service that does operate 24 hours a day 365 days a years is the fact that illness is unpredictable and this has a serious impact on people whose sole aim over the festive period is to indulge in a totally predictable uninterrupted period of gross calorie consumption of unnecessary food, copious amounts of alcohol and numerous workouts on the remote control to go for the burn.

They have worked, some of them have paid taxes and if illness interrupts any of this planned gross over indulgence it is not their fault and there is hell to pay for it for they want what they have paid for back. In general practice hell starts in the run up to Christmas for we all know that illness is always totally predictable and will always be made better by Christmas (as it is in the films?) for illness is never the patients’ fault but always the doctor’s responsibility.

Praise be to the Party for once again giving us Christmas and resurrecting the usual ghosts of Christmas past, present and the spectre of the Christmas to come in healthcare in the guise of our every giving patients so full of self centred Christmas spirit onto to all in healthcare.

Is it over yet?