As Martin finished his notes on the morning patients, he calculated how much time he would have for lunch. He knew there were plenty of options in the kitchen, but today he felt like getting some sea air. Perhaps a stroll down to the bakery…
There is a knock on the door. Martin automatically answered, "Yes?" without looking up. Although he knew he didn't have any more appointments until after lunch, there was always some citizen of Portwenn popping by to mention some pain or rash, often after several days of some pointless home treatment which inevitable made whatever minor ailment they originally had worse.
Morwenna stuck her head around the door. "Doc? Chris Parsons is here and wants a word. Not another patient til 2. Should I send him in?" Martin furrowed his brow. What would bring Chris all the way from Truro unannounced? It should be at least another month before he made is regular appointment to "discuss" the various complaints made to the PCT about rudeness or disrespect that whingers regularly lodged. They usually dispelled with the pretence quickly and then would catch up on the latest journal articles or treatment advances, and more recently raising children, over a cup of coffee. It was the closest thing to a chat that Martin ever participated in and as much as he enjoyed these visits, he doubted Chris would make a special trip for one.
"Erm. Yes, send him in and then you can take your lunch break."
A few moments later, Chris opened the door with a smile and closed the door behind him. "Martin, how are you?" "Fine," replied. Martin. "And how's Louisa and James? Both enjoying school?". "They're fine. And yes." Chris stood for a few seconds looking at Martin before sighing and taking a seat. Martin raised one eyebrow – this was not going to be good. "What trouble have you come to deliver?"
"Right. Straight to the point, then. Mart, there is a problem. I'm sure you're aware of the new reaches of the austerity programs. They're looking at the rising cost of healthcare. NHS budget cuts mean that we can't support as many village surgeries as we have now. There are cuts all over the country and Cornwall is no exception. Of course we can't leave people without proper care and we won't," he assured himself as much as Martin.
Martin's eyes narrowed. "Chris, what the hell does all that mean?"
"Well, in order to keep uninterrupted coverage at cost, we're going to have to combine the practice areas of Portwenn, Port Karreck and St. Tomas into one locale, serviced by one central medical staff. A sort of regional home office for medical care." Martin stared at him with a look Chris couldn't quite read so he plowed on. "Basically, one surgery will gain all the extra patients and the other two will remain as emergency-only offices or outposts but will not be fully staffed or supplied. In all likelihood, they will be sold off and replaced with small offices to keep supplies for first aid emergencies."
Martin noticed that Chris kept giving him the "reassuring smile". It was a name some of the other house doctors came up with for the half-smile many of them took on when telling a patient they needed major surgery, often punctuated with a slight nod, meant to convey the serious nature of the problem while convincing the patient they has nothing to worry about. It was an expression Martin had never mastered.
"What aren't you telling me?" Chris nodded and went on. "Well, Dr. Truscott in St. Tomas is 67. He's on the verge of retirement and when you add in that St. Tomas is the smallest of the 3 and therefore more easily subsumed into the others, it's pretty much out of the running. That leaves Portwenn and Port Karreck as the only viable options to remain open."
"I see, so what happens to the physician whose surgery is closed."
"Well, I should be able to offer the job of Alternating Locum." Martin frowned, "And what is that?" Chris continued. "Well, 2-3 days a week, he will assist the remaining physician in dealing with the influx of new patients and the other days he will be a locum around Cornwall. Or he can go private, though there's not much call for that North Cornwall." He smiled conspiratorially. "Still with London tourists and celebrities moving this way, perhaps he could charm a stable living out of them." He looked at Martin, and his smile faded. "Or not."
"So which surgery is closing?"
"Well, naturally I recommended Portwenn as remaining open. You have far more experience with an impeccable list of credentials. On a personal note, you have a family here in town and Griggs is single. Having a less secure job with odd hours would be harder on you as would uprooting should you choose to pursue options elsewhere."
"So," Martin surmised, "if the Head of the PCT wants me…"
"It's not that simple," Chris interrupted. "Unfortunately, this is change that is being spearheaded from London and there is a committee that will make the final decisions for Cornwall and Devon. My recommendation will carry a lot of weight, of course, but ultimately they must decide."
"I see." Now Martin could see the problem. Although he and Chris could shrug off those ridiculous complaints, it meant there was a trail of paperwork. If London committees loved anything, it was rifling through paper.
Chris could see Martin's brain turning this over and summarized what both of them were thinking. "Frankly, Mart, you're not helped your case. Dr. Griggs has made a lot of friends in the last 3 years. He attends all the monthly medical committee meetings and has a good rapport with everyone on the PCT. You rarely come to any and when you do, you manage to outrage or offend everyone in the room. Plus, his patients love him and they have been very fervent to keep their doc. Let's just say Portwenn hasn't been so vocal."
Martin sat back in his seat and let out a loud sigh. "So now what?"
"I'll push for you, but I am going to need your cooperation. Please make an effort to impress the committee on their visits and try to stay of the negative limelight. No ruining village festivals or scaring parents." He glanced at Martin. "At least for the next couple months."