I joined the Practice on the 1^stof November 1990, seamlessly following Mike Parson’s departure to become the first GP Pharmacy Advisor at the FHSA (Family Health Services Authority).  Now, of course, such immediate replacement of GPs is virtually unknown, and many Practices are waiting for several months, or even years, to find a replacement GP.  Absolute figures are disputed but nowadays there are probably thousands of GP vacancies in the UK: https://www.independent.co.uk/news/health/gp-vacancy-nhs-70-doctors-waiting-times-appointments-patient-safety-a8433596.html

It had been common for junior Partners to take three years before reaching parity of income.  I persuaded the Partners that, as I was committed to full participation in the development of the Practice, this timescale should be shortened. We settled on one year to parity.  The following November of 1991 came with a very nasty shock.  Back then, tax was paid a year in arrears  – now the self-employed (for that is what GP Partnerships are) are taxed on a current year basis.  Although I had received a year of reduced drawings as agreed, I found myself being taxed on a full quarter share of the Practice’s income for the year preceding my arrival.  We were completely devastated – how we didn’t cancel Christmas altogether, I don’t know!

For other reasons too, that first year in Practice was a baptism of fire.  Mike Parsons’ leaving, and my arrival, were followed by four further partnership changes within a ten-month period.  The two founding Partners, who had established the Practice in 1960, both retired: Gordon Spink in January 1991, and David Black in May 1991. Evelyn Beale left in March 1991, and set up a singlehanded Practice in the Lee-on-the Solent Health Centre, with the rest of us decamping from Lee, and working from our two main sites; and Janette Lloyd Joined the Partnership in August 1991.  I took the lead in computerising the Practice, and also worked with Barry Collins on the extension of the Privett Road surgery.

At the annual Medico-Legal Dinner, at the end of 1991, I was asked what was my next ambition, and I replied: “becoming Senior Partner, I suppose.” It was some 22 years later that I succeeded John Grocock as Senior Partner in 2012.  Despite all those extra years of experience, becoming Senior Partner was a real step up, and a daunting and challenging experience.  Ah, the arrogance of youth!

On 1.11.1990, I joined the GP Partnership of Dr. Spink and Partners.  I had completed my GP Training three months previously with Bob Lee at Alma Rd Surgery in Southampton.  In the intervening few months, I had done a two week single-handed holiday locum for a small husband and wife Practice in Highfield, Southampton, and then joined the SHOs (Senior House Officers) at Southampton General A&E department.

Competition for GP Partnerships was probably past its peak of the 1980s, but it was still very stiff.  Scouring the BMJ adverts for Practices, preferably in south Hampshire, I read an advert for a Partnership vacancy in Stubbington, an attractive area, and near to family.  We went to the address given, to look at the surgery, only to find it was a private house.  Perhaps I should have smelt a rat, but I applied anyway, and was subsequently invited to an informal visit.  Barry Collins, whose house it was we had seen, took me on a tour of the three surgery sites (Lee-on-the-Solent Health Centre and the two owned surgeries in Privett Road and Rowner Road).  Later, I was to realise that the route taken had focused on the more affluent area of Alverstoke – home to those affectionately called “the Alverstocracy.”

I don’t recall any formal interview, but I do remember the “trial by sherry,” a traditional way to assess the new couple – a spouse was needed to answer the phone while the doctor was out on calls!  I also remember being invited to a Partnership meeting.  These business meetings were held once a month, in one of the Partners’ houses.  I had a strong interest in the business side of General Practice, so was keen to show them my desire to contribute to Practice management.  The subject of Haslar Detention Centre (as it was called before a later Home Secretary renamed it Haslar Removal Centre, just to make a point) came up.  With Gordon Spink set to retire in the New Year, there was discussion about whether or not to continue providing GP services to Haslar. I had studied the accounts carefully, and said that the loss of income could not be easily recouped … without realising, I had volunteered myself to take over the role of the Detention Centre’s Medical Officer!  I remained the MO at Haslar until its closure in 2015, and this role was to prove to be a springboard to many opportunities in my later career.