The school most at large in government today of the science that makes numerology appear rigorous is that known as Etonomics. As much a sect as a school, Etonomics holds that austerity is the one true path. Governments, according to its theories, must grip the economy as a giant python might a fat pig, and squeeze it back into shape. Those parts of the economy that fail to get back in shape face cuts, savage cuts. Not just an ear here, or a trotter there: whole limbs have to come off. These are the teachings of Etonomics, and, strangely enough, they don’t work. The python may enjoy a snack, but the economy dies.
These musings arose as Dr No read a seriously erudite assessment of the failing of Etonomics here. The assessment is long, but a one line summary might be ‘you ain’t seen nothing yet’, perhaps suffixed with ‘and you may never, because Tory austerity is unachievable’. To reach this conclusion, Lanchester, the author, makes a distinction between ‘cuts’ and ‘austerity’. Cuts, says Lanchester, are real, and do the damage, while austerity is an orchestration, and a con.
A journey of a thousand miles begins from the spot under one’s feet.
These days, nothing really happens until it happens on social media. Apart from curmudgeonly old duffers like Dr No, anybody who is anything is busy on twitter. Why, even HRH is on twitter! The NHS, it seems, is all over twitter like pigeons all over Trafalgar Square. Hospital trusts, ambulance control centres, continence control services, you name them, there they are on twitter, tweeting away, like pigeons all over…
Hot Burning Coales, the enigmatic London GP who has for a time been a thorn in the side of the Royal College of GPs, is showing signs that she is about to start hammering at them like a pneumatic drill. She is alarmed by the absurd pattern of results from the College’s Clinical Skills Assessment, the ‘exit’ exam for trainee GPs. Her concern is that white British candidates go through on the nod, while Asian International (non-UK medical school - IMG) graduate candidates are systematically failed, on the grounds that they are not ‘one of us’. Certainly the raw figures appear to back up the suggestion that there is a case to be answered. The College’s own statistics (page 28 
Over the years Dr No has encountered a number of single handed general practices. His first encounter was on a Scottish island, as a student, in a practice made memorable by two things: the sweet malt smell from the oil drum sized barrel of beer that brewed beside the kitchen range, and the loan of the practice Land Rover, with a licence to roam the island. Later, as a locum, he found single-handed GPs on leave a reliable source of work: he could be transported, as if by a revolving door, to the seat of a single handed GP. For a week or two, he had eyes-only access to almost every aspect of the practice. He saw the intimate details first hand, not as a squinting sociologist might, but as a living participant. And living practices they certainly were, but pretty rum many of them were too. Too often for comfort, opening a drawer in search of a prescription pad, Dr No was greeted not with a jumble of papers, tongue depressors and broken tape measures, but with the clink-chink of bottles of high proof but non-surgical spirit.
A good traveller leaves no track