The standard chart that doctors use to determine the healthy weight for people of a particular height and body frame was first formulated soon after the Second World War and has not been modified since. At that time, because of the austerity of war time and food-rationing, and for some years afterwards the population was generally thin. Hence large numbers of the population nowadays, in more prosperous times, are defined as overweight or obese. These people, when they are also physically unfit through lack of regular exercise, tend to have a higher incidence of heart disease and diabetes. When they slim down, primary through reduced food intake, these risks are reduced.

People who are obese or overweight often protest that they eat very little. When observed under scientifically controlled conditions, however, their food intake is significantly and regularly larger than that of slimmer people. The plain fact is that fat comes from food – and it is impossible to remain overweight or obese (as concentration camps distressing illustrated) without maintaining a high intake of food.

The medical implications of this are obvious. Putting people on a diet is insufficient in itself. People who are obese or overweight do not keep to the prescribed diet. Doctors tend to prescribe medication that interferes with food absorption from the gut or they advise surgery to the stomach or intestines in order to reduce their absorptive capacity. A more appropriate approach is to determine (on the shorter PROMIS questionnaires on www.promis.co.uk) whether someone has an eating disorder and, if so, to advise him or
her to become totally abstinent from sugar and white flour (the substances that cause physical cravings) and to work the Twelve Step programme of Overeaters Anonymous, one day at a time for life.

The political implications for our present government are that they are aware of the considerable financial cost to the NHS of heart disease and diabetes and therefore they bribe general medical practitioners to monitor their patients’ body weight and do whatever they can to reduce it.

The political implications in the Atlee government, that created the NHS just after the Second World War, suddenly came home to me last week when I was watching a documentary made by Andrew Marr for the BBC. At a time of severe rationing of food, Nye Bevan, the Minister of Health, was grossly overweight. So was Ernest Bevin, the Foreign Secretary. Herbert Morrison, the Home Secretary, was not much better and even Harold Wilson, a junior minister, was certainly not slim. Where did all the food come from to maintain the body weight of these socialist fat cats? It certainly cannot have come from whatever they could have purchased through their ration books.

Twice recently people only a few years older than me have described themselves as being old. They are old if they see themselves that way.

The hare bounded down the road and I drove gently behind him making no attempt to catch him up but just waiting for him to turn off into the fields. He didn’t. It must have been three hundred yards before we eventually parted company. Thank you, hare, for our brief time together. I enjoyed that.

The old jokes were too tired to bear being repeated. When he was talking about his work he had a natural light touch that was very entertaining. I suppose he felt obliged to tell jokes. That isn’t his gift – and he didn’t need it.

I am not currently in touch with any of my friends from university or medical school. I have been too busy for simple courtesy and that isn’t right.

He expects me to make the arrangements for him to be admitted to a private hospital immediately when he arrives in the country tomorrow. I did it last time – and it ain’t that easy – but I am just a GP – a sorting office, not a real doctor.

In honour of the most famous split infinitive of all, I watched the film-length Star Trek: The Nemesis, on TV. It was very good. I became totally absorbed in it and so was Meg. She had watched Star Trek when our children were young. As a general medical practitioner, I was never home early enough. I missed out.

I’ve managed to get doctors to cover all the medical work in the Recovery Centre when I am there over the weekends. I could perfectly easily do it myself but I don’t want to. My primarily relationship with our patients is as a counsellor, not as a doctor. No longer can they side-track me when I challenge them on their thoughts, feelings or behaviour. I can stick to my task and let the doctors do theirs.

An American student specifically asked me for an x-ray of her knee and then objected to the cost of it. I take it for granted that I would have to pay for my medical care in the USA.

I think that what this contrast illustrates in microcosm is that some people take State medical care for granted and have no thought that resources have to be created and paid for by someone, whereas that should be obvious in a private system. This student knows perfectly well that I do not work for the NHS and she also knows that she has not contributed to it. Therefore the only explanation for her attitude is that she, along with many people in our own country, believes in funny money. In the UK we have a state system: it just exists and that’s that. Nobody has to pay for it. Nor should anyone pay for private services.

“Not”, as Borat learnt to say.

I’m annoyed to discover that some of my personal information leaked into general circulation among my staff, possibly because inappropriate people were given access to a particular computer terminal.

Now imagine what it would be like for families whose confidential social data is placed on government computers in order to search for any possibility of children being a risk. The cause may be worthy but the outcome may cause much more harm than good.

Then imagine the implications of the government’s plan for shared medical records between hospitals and general practice and see where that leads.

I acknowledge that mistakes can happen so I have no particular concern over the possible careless behaviour of some of my staff. My real concern is the power of government. I absolutely do not trust government officials nor state employees with confidential data. Tell something to one of them and potentially you tell them all – and there is an enormous number of them. Furthermore, they have their own set of values that can be very different from mine. Essentially they see the State as benign where as I see it as malevolent.