The past is a foreign country

My daughter came home from nursery a couple of weeks ago singing a new song that she had learnt that day. After the initial parental pride and pleasure at discovering that she had memorized it so quickly it made me think of the healthcare that she might expect in her dotage. The lyrics are worth repeating here - you will see why.

Miss Polly had a dolly that was sick, sick, sick
So she called for the doctor to come quick, quick, quick
The doctor came with his bag and his hat
And he knocked on the door with a rat-a-tat-tat.
He looked at the dolly and he shook his head
And he said "Miss Polly, put her straight to bed."
He wrote on a paper for a pill, pill, pill
"I'll be back in the morning - yes I will, will, will.

Doubtless you can already see where this is going. The utopian vision presented to the children here is of a rapid resonse personal service to the home - note the use of the definite article 'the' doctor: not any old doctor - her own family doctor. The traditional Victorian image of the frock coated physician persists as does the diminishing skill of clinical acumen - the ability to recognise sick patients is now no longer an assumed, not to say real part of the modern doctor that juniors are sent on compulsory courses to learn this vital art.
The part about treatment at home fits in well with the modern notions of healthcare so that is one area of which the old DoH doyens would approve but a paper prescription? Hardly the Connecting for Health ePrescribing on an electronic patient record, is it? As for the idea of continuity and follow up that is very rare these days. Shift patterns and the diminishing professionalism borne of clock-watching have seen to that.
So whilst we still wait to see what plans the coalition government has for our future and hope against hope that the top-down micromanagement goes with the legions of unnecessary administrators, I propose a modern version of the same song.

Miss Polly had a dolly that was sick, sick, sick
So she called the approved emergency number for out of hours consultations
A locum said: "Can you come to the local walk-in centre?"
Where he sat with his arms bare below the elbow and no tie.
He entered the dolly's vital signs into his computer and said:
"She doesn't fulfil the criteria for antibiotics so give her Calpol instead",
"I'll arrange for one of the nurses to ring you up in the morning to see if she is any better."

Not all change is progress.