On Sunday 12 December 2004 16:00, Paul Bromley uncharacteristically top-posted
quoting in full:
> Adrian - I assume from what you have been saying that you don't fill in and
> sign the first part of the crem form??
Why assume that?
The suggested evolution of the process of certification and disposal is for
the death certificate that we currently have a statutory duty to complete to
incorporate some or most of the detail on the Cremation Form B.
THis seems to me not unreasonable - the death cert is largely duplicated by
the Form A and that removes one piece of paper from our load, the death cert
is widely felt to have too little information on it to fulfil all of its
various purposes, and thus it seems reasonable to gether more data, what I
am not entirely convinced of is that it is our duty or talent to do so.
In any case I see no added hazard or uncertainty in completing Form B and if
someone wishes me to do so I am prepared to do so, as a piece of
non-statutory extra-contractual work and therefore under a separate contract
with the requestor.
> If you are still signing the first
> part, who is signing the second part for you?
Another of the suggestions, I know not what status it has attained, is that
the "cosy" system of picking out who will sign a form for you and expecting
that a reciprocal arrangement will be made is not entirely free from the
possibility of criticism. Locally, a Practice who are pleased to regard
themselves as excellent and reputable and must be certain of perfection in
every matter related to clinical governance chose some time (2 years?) ago to
allocate Cert C investigation and signing at (pseudo) random IE the duty
partner was to do it.
(I suspect that this was in fact to overcome the unwillingness of certain
partners to exert their full efforts to obtaining income for the partnership
by requiring them to take on such jobs when offered, but it was _presented_
with the clinical governance whiter than most sorts of snow* so I suppose it
should be assessed on that basis.)
I feel quite reasonable in dealing with the two parts as separate contracts,
and allowing a different sort of pseudo random allocation of a second doctor.
Finding or selecting one is no part of my duties. Nor is disbursing their
payment, nor, inter alia, does the presence or absence of a Part C signed
affect the work I have done or the fee I expect.
> If someone is signing the
> second part for you then surely this goodwill will dry up soon.
The goodwill if any is in one opinion improper, and in my own solely that
between the second doctor and the family. It can't be sold either way.
> Whilst I agree that we should revolt on this one, I see it as unworkable.
I don't see it as a revolt. I do what I think right, you do what you think
right, he will do what he thinks right.
By all means think globally, but action in this is surely local.
> We both
> know that most GPs will carry on signing and the ones that prefer not to
> will be seen as the villains of this one.
We are all terribly busy people, are we not?
> If I were one of the Hyde GPs, I
> would not want to go near anything to do with cremation certification again
> - in any shape or form.
Indeed so. A survival instinct honed by the scary sight of a sabre-toothed
tiger or a cave bear in a cave, long long ago.
Later, e developed language, and became able to scare each other with stories
- like a story about bad things happening to people who do X.
X, I submit, is perhaps as well left to not be done, or to be done by someone
else.
> However, as I remarked earlier, I think you should feel uncomfortable about
> signing them well before you get to the stage of speaking to the relatives
> - it is not clear to me how anyone involved is going to make it sensible
> for us
> to feel compfortable again.
>
> But that, _now_ is _their_ problem.
* the Eskimo, the late Douglas Adams told us, have many words for snow,
including one for the patch of snow the Huskies have just turned yellow. I
mean whiter than many other sorts, and not just that sort of snow, OK?
--
Dr Adrian Midgley GP Exeter www.defoam.net
Open Source is a necessary but not of itself sufficient condition.
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