There is a point beyond which I stop being amazed and simply despair. A recent poll by the Medical Protection Society has found that 40% of patients think they should be able to amend their medical records without their doctor’s approval, and – wait for it! – three quarters of patients believe their records should be written in simple language, avoiding medical jargon and terminology.

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What have Earth, Vulcan, Tellar, Andoria, and Alpha Centauri got in common?

Right now there are two kinds of people reading this – the ones who will die a slow painful death trying to look for a connection, stars? moons? book characters?- and the ones who will reach old age and grow rich because they know the answer.

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In my time I’ve done my fair share of out-of-hours work. I still do a bit when the registrars need experience. It is without doubt one of the most challenging facets of general practice.

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The Guardian reported a leaked document this week which disclosed that HM Revenue and Customs (HMRC) was paid £4.5bn from four ‘sweetheart deals’.

These are arrangements that HMRC comes to with taxpayers. Now that sounds like a lot of money to you and me, but as Margaret Hodge, chairwoman of the Public Accounts Committee asked: ‘How much did they not get?’

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Whenever an ultra-successful Roman general was awarded a ‘triumph’ – a procession through Rome with captives and booty – he had in the back of his chariot a slave whose sole job was to repeat, time and again, ‘Remember — you are only a man’.

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I’m open to what’s-his-name being a substitute. Lets face it, the Silver Fox was the real health secretary, but he didn’t get to the promised land. Even so, as a substitute he’s gone a bit Louis Suarez and then some.

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I have had a number of GP clients who have taken over or merged with other practices, some have done well, and others fared worse.

The reasons are complex, but to put it into a simple sentence, the success stories are where the more successful practice gets involved with the less successful.

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I was speaking to a GP client this morning, discussing the current state of general practice and the depressingly familiar view of the future when an email message popped up on my screen: ‘Hunt wrong to scapegoat GPs for pressure on A&E’.

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‘What’s my motivation here?’ is apparently a phrase which actors use to ‘explore their characters’.

It’s an interesting concept, perhaps one we might think about applying to our medical practices. All those parents who thought I was jabbing their little prince or princess out of pecuniary interest should look at the storm of activity in Swansea to realise that sometimes as GPs we work for a higher cause than money.

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An open letter to the GMC.

Dear Sir Peter,

I was concerned to receive the GMC’s recommendations about doctors’ use of social media — particularly that doctors who blog, tweet or use Facebook should identify themselves. As you will know, this has caused a great deal of consternation among many anonymous medical bloggers.

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My other, some say better, half – Madame Custodes comes from a nation across the water, not the Isle of Wight, but further afield. A country where small men with much taller, beautiful partners tend to rule.

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If you have a spare moment or two and you want to find out how the funding of GP premises works, the GMS Premises Cost Directions 2013 make interesting reading.

It covers all forms of reimbursement, for those GPs to pay rent and those who own their own surgery.

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The more I see of the NHS post-Francis, the more uneasy I’ve become. A slow progression of events has led me to feel that there is something extremely unpleasant lurking underneath. And I mean really unpleasant.

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The honeymoon is here. The engagement took a long time, and the ceremony was very public but we’re finally in bed together, really doing it, committed together forever.

Thing is, I remember her being a lot more attractive when we first stated going out. She was going to take my name, engage me in her plans, had lots of money, promised freedom, no strings attached.

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