April Book: 'The Constant Gardener' / John Le Carré
  Excellently led by Vicky Aspin, everyone pitched into an extremely lively discussion of this controversial novel by one of the great masters of corrupt state against nearly disillusioned campaigners fiction (remember George Smiley?). Young firebrand idealist, wife of much older British diplomat in Nairobi, discovers very nasty dealing by drug conglomerate using local women as guinea-pigs for as yet inadequately tested drug. Early on she and her equally driven companion are murdered by person or persons unknown, except that we get to unravel who might have a very keen interest in snuffing out their curiosity - ad there are surprises on this until the very last pages. Collusion in embarrassed high places in the FCO in Whitehall, murderous locals, obscenely rich entrepreneurs and dodgy but shadowy research teams all come together against the brilliantly documented African background, as idealist's devastated now widower husband belatedly takes up her cause, turns over lots of stones world-wide - at considerable risk to himself - to find slimy creepy crawlies who prefer the dark. The book divided the group: some found it tortuous, rambling, stylistically awkward, and unconvincing; others found the subject matter compelling, the angry Le Carré indictment of scary international secrecy kept the slightly rag bag book going urgently forward; one found in it a religious allegory, many found the women sketchy stereotypes - Le Carré himself seemed to concur with that judgement! The recent award-winning film was mentioned surprisingly little, and some had researched some of Le Carré's own listed sources to unearth real horror stories, thus bringing the message of the book leaping off the page into real life.
  For May, one of the greatest but truly accessible writers of modern times - Cat's Eye by the Canadian author Margaret Atwood. Victim of girls' bullying at school returns years later to confront her demons - or does she?
Discussion Programme:
May
Cat's Eye  /  Margaret Atwood
June
One Hundred Years of Solitude  /   Gabriel Garcia Marquez
July
The Colour  /  Rose Tremain
August
The Great Gatsby  /   F Scott Fitzgerald
September
White Mughals  /  William Dalrymple
October
Northern Lights  /  Phillip Pullman
November
The English  /  Jeremy Paxman
December
Georgina Duchess of Devonshire  /  Amanda Foreman
January 07
White Teeth  /  Zadie Smith
  £1 sub per meeting  / Second Monday in each month / 3 p.m. Sedbergh Town Library. Contact / borrowing of copy details: Janet Dodds Tel: 20308.

  As part of our willingness to listen to patient feedback, we have been reviewing the latest patient satisfaction questionnaire. Overall the practice did well, achieving a 68% satisfaction rating (national average 62%), a similar score to last year. Given the amount of change there has had to be, this reflects well on the staff and systems within Sedbergh Medical Practice. Comments suggesting areas to improve were made about a lack of access to evening and weekend appointments, along with the current phone system and the background music.
  Evening and weekend surgeries are difficult to provide in a small practice such as Sedbergh. With the current working day for any Doctor in Sedbergh lasting 11 hours then extending appointments past the general limit of 6pm weekdays raises the problem of tired Doctors. There is also a legal obligation to cover from 8am to 6.30 pm. This can be matched in a large group practice with evening appointments provided by GP's starting later in the day, often at lunchtime. In a small practice with limited personnel there is no ability to start later in the day, as mornings are where our main demand arises. Likewise providing Saturday surgeries means that the consultation time has to be balanced (taken off) in the week. It is in the interests of all concerned that GP's whilst working hard have time to take breath, to learn, to see their families, develop interests outside medicine and have the right on occasion to say no.
  Quality is paramount, along with the duty to learn and maintain knowledge. Please remember that less than 40% of the modern GP workload is face to face consultations with patients. If Sedbergh is to avoid being left behind in new NHS developments then the necessary participation in regional management meetings takes time. Standards and expectations are rightly high and along with clear accountability for all actions this means that GP's will not be available as much as the patient's would wish, or have previously experienced. Another absolute is that of confidentiality, and to that end we now play a mix of speech and music radio (with the appropriate licence) to try and deal with some of the problems that the design of the current building causes. As this will only be resolved with alterations to the health centre (currently in negotiation) than unfortunately the music in its current form has to stay.
  In response to reported problems with contacting the GP reception via the new phone system, there has been a survey of user experience and a follow up of individual complaints. Some 95% of users expressed satisfaction with the phone system, and those reporting trouble seemed to be calling at the busy times (we immediately follow up all reports of problems). Currently there is only space for one receptionist to answer calls, and in the old days the phone would have been engaged. Now callers enter the system but there seems no ability to stack callers. We are currently reviewing the system functions and will resolve all issues. In the meantime can I remind callers requesting medication to use the direct prescription line (20239) which has a 24 hour answer phone, or if your phone call is not time critical try and ring in the afternoon when the lines are less busy. Within the next 6 months a web site will be up and running which will allow on-line appointment booking, prescription requesting and electronic messaging.
  We now have an ISDN telephone line into the Methodist Church Hall in Dent and have equipment on order that will allow computer access from Dent to the surgery in Sedbergh. This should provide the same level of access to patient records when seeing a patient at the Dent clinic as if the patient was being seen in Sedbergh. It is hoped to have the new facility commissioned over the summer. This development clearly improves the service we offer for registered patients living in Dentdale.
  Finally it is worth announcing that we have achieved the maximum 1050 Quality Points for the year 2005/6. This is a significant event and reflects well on all members of staff within Sedbergh Medical Practice who have worked hard over the past year. Quality points are part of a national standard that is rigorously assessed and as the title suggests are all about providing a quality service in General Practice. In this respect Sedbergh Medical Practice has been graded as a Quality Provider of Primary Health Care Services.                                                                                     Dr William Lumb

  Well "March many weathers" lived up to its name we had a bit of all sorts, snow, blow, rain, frost and the odd patch of sun. It came in a bit blustery, hardly like a lion but if left  us rather more lion like with a depression and strongish winds. The maximum wind speed recorded was 26.2mph from the north west though again I suspect some filtering from by nearby trees. The pressure dropped below 29 inches of mercury for the last week corresponding with the blustery but slightly milder temperatures. The maximum temperature was recorded during this period of 57.7F. The minimum temperature was recorded on the 4^th with a low of 12.2F(!!!!!!!!) Interestingly the windchill that night was only 12F due to the westerly and slightly less forceful blow no doubt. We had some bitterly cold winds during the month with windchill temperatures in single figures. Twice during the month we had falls of snow of about 3 inches. This seems to bamboozzle my rain gauge which works on a lever system setting off an electrical trip. That amount of snow corresponds to 0.3 inches of rain but my instruments did not record it. Half way through the month we had measured approximately an inch of rainfall but the latter half made up for this and we ended up with 5.14 inches, the wettest month so far this year. They talk of water shortages even my ducks have wellies!! India is talking about putting in a national grid for water at a cost of $200 billion. If they can do it I'm sure we could we've done it once for North Sea gas.
  The low temperatures and cold winds didn't seem to hold up the surge of spring much. A pair of  blackbirds have nested in our shippon so let's hope that they avoid the attentions of the magpies. Both wren and robin have also been investigating the shipponn so let's hope they build too. On the milder days bees were working the remaining snowdrops and hellebores and slugs were out at nights. The grass started to grow towards the end of the month so the sheep were less interested in hay. I found the first female hazel catins during the last week of the month whether we shall see any nuts depends if the winds drop a little so the pollen isn't sent into orbit. There was a good show of daffodils later in the month but instead of fluttering and dancing in the breeze they were battered by rain and strong winds. The curlew made a re-appearance on the 15^th and his mate a fortnight later. There has been some largish flocks of fieldfares about probably getting ready to move back north as they don't seem to hang around. Having said that there doesn't seem to be much food left in the hedgerows in the way of berries or anything else for that matter. Our nuts, fat balls and mixed seed have had regular visitors including longtailed tits several times.