Friday, June 1, 2012

What's luck got to do with it?



Today I am in the mood to tell a story...don't know why..maybe it's just that there's a long weekend starting...maybe I am just in a good mood...maybe the fact I am travelling to the big smoke....whatever be the reason..definitely in a story telling mood. So how does one do that again...oh yes..."Once upon a time"....Ok, so here goes...

Once upon a time, in a far away land called Pompeyshire, there used to live in the big castle a posse of big bad dragons..also called Consultants. In the villages, the commoners or the GPs used to live amongst themselves afraid of the dragons who used to scare them into sending them gifts called patients to the castle of sugar....who the dragons feasted upon. The dragons grew stronger, they had all the wealth..and the villagers cowed down ..wondering when their shining knight would arrive. And then they did..they were called PCTs or Commissioners...they started to stop sending gifts..the dragons snapped, snarled...while the commoners looked on. The impasse grew, the dragons fought hard...and then one day, the unthinkable happened. The commoners became the knights themselves, they had access to shiny weapons and throughout the land of Britain, it was clear..the end of the dragons were nigh. The dragons were after all beasts to be feared...the myth was strong,they belched fire, took pleasure in chomping on the gifts offered slowly...nothing was spared!! Well deserved..the mob shouted...they bayed for blood....down with their heads, screamed someone....and then something happened. A little girl squeaked..."But I haven't seen any dragon, mummy, have you?"

Throughout the swirling crowds, the whispers spread like wildfire..surely someone had seen these mystical creatures....it couldn't all be old wives tales..they were horrible, arrogant, fire spewing obnoxious beasts...someone must have seen them?? Somebody? Anybody?....And slowly it dawned on all that no one actually had seen this dragon...over the ages it had been handed down how dreadful they were...but nope..no one had "actually" seen the beast!!

But throughout the land, these dragons sulked in their castles..angry at not being the ones who could rule with fear..they had lost their powers...and they felt..hurt. Hurt at being left out, hurt at being ignored...they may have been labelled as dragons...but they weren't...in their mind, they were tying to help. All those gifts the villagers sent..they hadn't destroyed them, they had looked after them..they had tried to make things better for everybody...so what happened?? just because they hadn't wanted to speak to the villagers when they had the powers..surely that didn't mean they should be left out now, should it?

But the times were changing and in the shire of Pompey, the dragons thought different...they got together and hatched a nefarious plot to steal back the higher ground. There was the Professorax ( sorry if I am mixing my dragons up with dinosaurs!) sage like...nodding at suggestions while chewing on his favourite diet..lipids...there was Iainosaurus who put forward lots of questions but kept playing with his gadgets and regularly turned up late for the meetings, Darrylex..prone to bursting into anger at the incompetence of the system but happy to calm down once given a few feet to chomp on..and then there was Karosauros..the young buck who thought he had the answer to everything and the rest agreed that he actually needed a hair cut. But between them, those dinos were clever...cunning. They thought of something incredibly dastardly, something that would make young readers blood curdle....they decided...here it comes...to join the villagers!!!
The senior dinos thought that copious amount of disguise would be needed while the younger one thought they actually looked a lot like the villagers! Anyhow, after lots of debate, (mostly because Iainosaurus had triple booked himself into playing with his toys AND dealing with the rare gifts arriving from the villages AND the meeting of course), Karosauros was sent out to meet the villagers....

The villagers were cautious...but then it was discovered that the dinos and the villagers could actually live together. The gifts they had sent to the sugar castle hadn't been devoured, the villagers found some of them had actually been well looked after. The dragons promised to be less fearsome, promised to go to the local inn to mingle with all, the villagers accepted there were prejudices on both sides...they all had a big party together and danced the night away in merriment. And of course they hoped to live happily ever after. End of story.

So why, I am sure, you ask, do I tell you this story? You know why? Simply because I want to bury a sweeping generalisation that Consultants are not being involved in any Commissioning decision. That may very well be true and I am sure the faults for that lie with either or both sides..either the Consultants refuse to engage, refuse to change or the Commissioners concerned are so obsessed with the necessity to save money, appropriate clinical care, nay, SAFE clinical care has gone out of the window.

Locally however it's been a different story- or at least as far as diabetes has been concerned. I am sure there are plenty of challenges ahead and not for a moment would I suggest it's "all ok" but whatever you do, you certainly cannot accuse the Commissioners of not engaging with the Consultants. People have said we are "lucky"... So let me bristle suitably at that suggestion...luck had nothing to do with it, amigos. I would love to take credit for all that has been achieved, the contracts signed, the acceptance of the Super Six model, the bidding process etc....but I simply can't. The has been some fabulous people on the way, who have helped immensely. apart from my colleagues ( Mike, Iain,Darryl) standing by me, allowing me as the most junior colleague to run the gauntlet, putting express faith in me..from the hospital Executives such as Simon, Ursula,Richard to the "old style" Commissioners such as Melissa and Jo, to the new power bases i.e. GP Commissioners such as Andrew,Koyih,Barbara and Jim....it has been a fabulous joint effort. Thank you all for being there over such a long and tiresome journey...but you know what..at least we have finished the process...now to get on and do the most important job ergo get patient care better. Luck has had nothing to do with it..it's been the coming together of lots of people who have just wanted to do good..wanted to help.

Is that my way of blowing smoke or sucking up to anyone I mentioned? What can I say...if you think I would indulge in such things, then you don't know me enough. But yes, I am not that arrogant either to not take a pause and thank those who made it happen. I remember evenings coming out of meetings late at night, with even my legendary confidence dented..only to turn around and see someone like Jim put a hand on your shoulder and say..don't worry, keep at it..we will get it done. When a GP Commissioner tells you that late on a Thursday evening, you smile, charge up the energy shields and...go again. When Darryl turns around and says "We want you to lead this, as you can make it happen".. You don't think of it as empty talk..it gives you renewed vigour to join swords over a negotiating table..one more time. So..you know what...this is my way of saying...Thank you.

Much more to do but the relationships are now built. There is a belief and a trust that is mutual and as Consultants, we don't feel out of the loop anymore. We are involved in it, in the thick of it...and the team consists of Consultants, GPs, Managers...all on a equal footing. So the dragons and the villagers got together...and they both got to know each other. That happened as both gave each other a chance.

So..I ask you again...what's luck got to do with it?

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