Mary Dejevsky: Let's choose our GPs – and much more too

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The Independent Online

For a long time government ministers bombarded us with talk of "choice", without offering much that anyone could really exercise. There's no point in having "school choice", for instance, if there are only two substandard comprehensives with places.

Now that "choice" has almost vanished from the government's lexicon, however, lo and behold, the Health Secretary, Andy Burnham, has given an undertaking that might have made many of us less sceptical about choice, had it been offered to us rather earlier: the possibility to choose a GP beyond the fixed catchment area determined by where we live.

A small bouquet, first. Mr Burnham seems to have undergone some "communications" training and, miraculously, come out a vastly more convincing performer the other side. He seems also to understand that convenience looms almost as large for many people as anything else. The opportunity to register, for instance, with a surgery close to your job rather than your home could be a big plus for those who work long or irregular hours.

For many others, I suspect, the new flexibility might be used less to move away from an unsatisfactory GP practice – transferring in these circumstances is fairly well established, so long as there is another surgery in your area – than to hang on to a GP you like. For those who have had the same doctor for many years, moving closer to relatives or into sheltered housing, say, even in a nearby town, holds a big additional fear: the loss of a congenial and familiar GP. If they can move without having to change doctors, one large, and underestimated deterrent will be removed.

And when GPs object, as some already have, that house calls could be difficult, they are being disingenuous. Anyone living far from the surgery will build that into their decision. But GPs, having delegated out-of-hours work almost entirely to deputising services, can hardly claim sole rights over patients when it suddenly suits them.

If Mr Burnham is serious about patients' convenience, however, he needs to go quite a bit further. Allowing people to undergo routine tests at a hospital of their choice, not confined to their particular health district, would be progress. I can practically see two teaching hospitals from my bedroom window, but I am summoned miles away for mammograms and the like, because of where the boundaries are drawn. It's all, of course, about money: my attendance is part of meeting their targets. But that means it's more about them than about me. No wonder so many people fail to turn up.

There must also be much less quibbling about relatively small costs. My husband, who had a pioneering operation in another part of the country, was brought to London for a day of tests. A summit-level dispute broke out about who would pay for his transport home (not from the other city, but across London!), because it did not fit into any category. When we offered to order a taxi, the other trust, that had brought him to London, decided its transport could quietly make the minor detour. Of such petty sillinesses are patients' dissatisfactions made.

* I am bereft without my mobile phone, surely one of the inventions of all time, and Finland could have no greater fan than me. But oh that ring-tone! And we are hearing more of it. Not, I suspect, because more people are buying Nokias, but because the standard options no longer include a plain ring-tone; you accept the Nokia jingle in some form or fork out for something different. You can imagine Nokia thinking it a good way to raise its profile. But when does a raised profile, if it's irritating enough, become a turn-off? Maybe Nokia is about to find out.

A diva in dangerous territory

The last Night of the Proms, with its staples – "Rule Britannia", "Jerusalem", "Land of Hope and Glory" and all those flags – has long provided an outlet for populist patriotism, and the mezzo-soprano Sarah Connolly entered fully into the spirit of it all last Saturday, dressing up as Nelson to sing "Rule Britannia" and unleashing a large Union Jack from her sword. It was clearly meant as a bit of fun and she received a rapturous reception, so why – watching on television – did I feel a slight unease?

Somehow there seemed to be an extra edge this year, a strand of serious jingoism alongside the usual irony and, yes, the fun. In recent years, the Royals and the politicians have tended, graciously, to leave the people to it. Even the Prime Minister, for all his desire to foster "British-ness", has seemed unwilling to harness this annual bout of imperialist nostalgia to the cause.

But this year I wondered for the first time whether officialdom in all its guises was not being too blasé, and therefore blind, to a potentially malign shift in the national mood. I also wonder whether my misgivings might not be more widely shared. Ms Connolly sang "Rule Britannia" for as long as it takes, sang an encore and took several bows. Finding a picture of her in full rig-out, however, was no simple matter. I found only a couple far down the selection on standard search-engines and none at all on her website. Savour this one while you can.

A lesson for life in an errant balloon

The back end of Waterloo station – but it could have been almost anywhere in the world. A man, a woman, a toddler and a smaller child in a pushchair, holding an orange balloon by a string. All of them are looking up, wordlessly, to where a second orange balloon is floating higher and higher into the sky.

There was a moment when it looked as though the balloon might, impossibly, fall to earth. But, of course, it was no time at all before it was but a speck against the clouds, the toddler was being consoled, and the family group made its way into the station. Consider the lessons for life: don't hanker after what cannot be; seize the moment; know when to cut your losses; all worldly things are transient; material possessions are not everything.

But perhaps the message for the toddler was more prosaic: next time, just hang on to that string.

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