Q&A: Phil Peverley, GP and columnist

DR PHIL PEVERLEY is a GP in Sunderland and best known as the acerbic contributor of a regular column to the weekly primary care magazine Pulse. He qualified in 1987 at Newcastle and spent five years as a wandering SHO before taking up a GP training post in Northumbria. He says: “Looking back on it, it was not until I actually started as a GP registrar that I discovered that general practice was all I had ever wanted to do.”

Are you a real person as opposed to your colleague Copperfield at Pulse?

Yes, that’s the name I was born with. That’s a picture of me. I really am a Sunderland GP and my home address and phone number are in the book. Anyone can find them. I took the decision not to use a pseudonym on day one; partly because I stand by everything I write and partly because I like to see my name in the paper. Copperfield is real too, of course. Both of him*.

How did you get into writing?

Football fanzines. I’m a Hartlepool United supporter (and now their club doctor) and about fifteen years ago I used to submit articles to the Hartlepool fanzine Monkey Business. The first one was, as I recall, an analysis of baldy footballers in the lower divisions, with humorous pictures. This was a lot of fun but the pay (a free copy of Monkey Business) left something to be desired, so I wrote an ‘In My View’ piece for the now sadly defunct Doctor magazine and have been hitting, and occasionally missing, deadlines ever since.

Suppose you wake up one morning and find you’re Andrew Lansley. What’s the first thing you do?

Roll over and say hello to Mrs Lansley. I’m no fool. Later in the day, it’s harder to say. I profoundly object to politicians telling me how to do my job, so I don’t really feel comfortable reversing the situation. Possibly I’d direct some of my minions to work out just exactly what it costs to run NHS Direct and Walk-in Centres, and compare, pound for pound, just exactly how much clinical work they do compared to traditional general practices. I know the answer intuitively but it would be nice to have the figures so that I could close the lot down in good conscience.

Do you think real patient choice is possible in a national health service?

Patient choice is nothing but a political buzzword. From the patient’s point of view, it’s a distraction. When we were first forced to introduce this concept, I used to ask my patients where they would like to be referred. I had a list of local hospitals, and I would ask where the patient would like to be treated. Invariably, this would be met with a look of blank incomprehension. “Er, that one” they would say, pointing at the big hospital visible from my consulting room window. I don’t bother asking these days.

Do ‘market principles’ have a place?

A resounding no. Since I’ve been involved in practice-based commissioning I’ve become aware of the vast army of NHS administrators who are involved in doing nothing else but attempting to move money from one bit of the NHS to another bit of the NHS. This is insane; all the money comes from the same place, ultimately. Why employ literally thousands of adminidroids to argue over which specific budget it all comes out of? It frankly doesn’t matter.

What threats do you see for UK general practice today?

Nurse practitioners are the worst one. As an experienced GP and a GP trainer, I know exactly how difficult and complex general practice can be. We don’t let just any doctor be a GP these days. The training is long, arduous, expensive and, in the end, justifiably elitist. You’ve got to be bloody good to get your certificate, and rightly so. However, NHS Direct, walk-in centres, Darzi clinics and even some Judas general practitioners seem to think that nurses who have done a superficial three-month conversion course can be trusted to see unfiltered primary care problems and deal with them. This is dangerous thinking.

Sometimes in your column you seem… how to put it…rather grumpy and miserable. Is this a misconception?

If it’s possible to get laughs out of Darzi Clinics and revalidation, I’d love to know how to do it. Sometimes the subject dictates the tone. But foam-flecked splenetic ranting is a wonderful way to relax, and sometimes I sit back from the computer with bloodied fingertips and sigh “Ooh, that’s better!” I get it down on the page, so it doesn’t fester in my soul.

Do you have any regrets?

I’ve had a few. But then again … no, there was one thing. I was a student in Newcastle in the eighties. This bloke used to come round the pubs selling his homemade magazine; I liked it and kept buying it. The magazine was called Viz Comic and I owned most of the first ten copies, each of which is worth literally thousands today. I regret lending them to a friend of mine, because he threw them out.

Interview by Jim Killgore, editor of MDDUS Summons

*Pulse columnist Dr Tony Copperfield is the "pseudonymous creation" of two GPs