Intended for healthcare professionals

General Practice

The wizard and the gatekeeper: of castles and contracts

BMJ 1995; 310 doi: (Published 22 April 1995) Cite this as: BMJ 1995;310:1042
  1. Barbara Herd, consultant physiciana,
  2. Andrew Herd, general practitionerb,
  3. Nigel Mathers, senior lecturerc
  1. a North Tees NHS Trust, Stockton, Cleveland TS19 8PE
  2. b Health Centre, Spennymoor, County Durham DL16 6ED
  3. c Department of General Practice, Medical School, Sheffield S10 2RX
  • Accepted 24 March 1995

The wizards and the gatekeepers were unhappy. There were many reasons for their unhappiness. They worked hard but felt that too much was being demanded of them. The poorly people's charter was resulting in unrealistic expectations, and changes in the apprenticeship for wizards were putting great strain on their mentors. The wizards enjoyed their work less and less, and it was getting difficult to find new gatekeepers. On the other hand, the way the system worked meant that there had to be plenty of goblins and the number of scrolls that had to be filled in was rising sharply. The wizards and gatekeepers tried to point out ways to improve things that would ensure that poorly people were better treated, but there was no easy solution. With the ominous sign that the recruitment of wizards and gatekeepers was becoming more difficult, an answer was needed—and soon.

The wizards and the gatekeepers were very unhappy.1 2 Once upon a time they had enjoyed their work of looking after the poorly people of the kingdom and had felt appreciated. They had always worked hard and done their best, and even when their magic potions hadn't worked (which sometimes happened) the poorly people and their families knew that they had done their best and were grateful.

Things had changed. Although there were lots more wizards and gatekeepers, with better spells and magic potions, all was not well in the kingdom. The king was worried that he was not very popular and needed more support from his people. “Sire,” whispered his chancellor, “you need a big idea if you want to stay king.”

The king thought very hard about this. “Surely the charters3 were a big idea?” he asked.

“Why not make them bigger and better?” suggested the chancellor. “The goblins can …

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