Recently Mrs K brought her son to see me. She had waited a few days for an appointment. I was expecting to see the results of an outpatient appointment requested locally with the dermatologists.

To my surprise she told me the appointment had been made - but it was for three months' time. 'OK, ' I responded. 'How can I help?'

'Well, we rang the hospital to say we were available at short notice, should there be a cancellation or did not-attend.'

'Excellent. Er. . . How can I help?'' 'The hospital told me I had to see my GP, and he would write them a letter saying my son could attend at short notice or fill in for a DNA. . .'

For once, words failed me. How can we hope to get through the real work when even our own side tries its hardest to make it impossible?

Dr Roy Sharma Gloucestershire