In this week’s instalment of our fly-on-the-wall documentary about the working lives of doctors, an NHS finance director discusses a delicate matter with her GP
Doctor: What can I do for you today?
Patient: It’s a bit embarrassing. I’d rather not talk about it
Doctor: There’s nothing you can tell me that I haven’t heard before
Patient: You won’t tell anyone else?
Doctor: I’ve taken an oath
Patient: I’m worried that I’m becoming a compulsive liar. I simply can’t tell the truth any more
Doctor: I see. Why is that a problem for you?
Patient: I’ll be sacked if I tell the truth
Doctor: I find that hard to believe
Patient: No, honestly. I’m not lying – at least not about that
Doctor: Why do you feel the urge to lie?
Patient: It’s the only way I can keep other people happy – the chief executive, other members of the board, NHS Improvement, NHS England
Doctor: And you’d rather tell the truth?
Patient: God, no! The truth is far worse
Doctor: Do the people you’ve mentioned know that you’re lying to them?
Doctor: And they don’t mind?
Patient: No, they prefer it. In fact, they insist. They’re all doing it too
Doctor: Have you ever tried telling the truth?
Patient: I tried it last year. I said we couldn’t meet our financial targets. Everyone was furious
Doctor: Because it wasn’t true?
Patient: No, because it was
Doctor: What happened?
Patient: We didn’t get our transformation funding
Doctor: Which is…?
Patient: The extra cash we need to transform the balance sheet
Doctor: I see, so other people are rewarding you for lying? That’s very unhealthy
Patient: Maybe, but it’s better than being punished for telling the truth
Doctor: If everyone’s lying surely you have nothing to worry about
Patient: I’ll have plenty to worry about at the end of the financial year when the truth comes out
Doctor: Just tell them you were all in it together
Patient: The board will deny it. They’ll say the figures I gave them showed that everything was fine
Doctor: And do they?
Patient: Yes, but only because they told me to make them up
Doctor: So, what do you want me to do?
Patient: I hoped you could give me something for it
Doctor: I could give you the name of my accountant or a short course of anti-depressants
Patient: I think I need something stronger or I’m not sure I’ll get through next winter
Doctor: Did you have something in mind?
Patient: Ten million should do it
Doctor (writing prescription): Take this to the pharmacy. You should feel better in a couple of days
Patient: Is it a cheque?
Doctor: No, not really, but I have other patients to see and your time’s up
Patient: Thank you for being so honest with me, doctor
Doctor: Not at all. Send in the next liar on your way out
Editorial regulator: Julian Patterson
Reproduced at TrainingPrimaryCare.com by kind permission of Julian Patterson.