Iron Man and Thor move over for some new superheroes: the PPwT – that’s planned procedures with a threshold – solved all the NHS’s problems yesterday.

To fight evil referrals they have asked referring GPs to now send two forms (a referral form and PPwT form), unless you’re just asking for an opinion like 90% of referrals are, in which case don’t change anything. Ta-dah! That’s it. This alone will cut referrals, plus the size of that pesky Amazon forest which is just taking up too much space isn’t it?

Unconvinced? Well egg on your face, because it’s guaranteed to be a 100% success. Since only forms that have been received can be reviewed, and since the review process is simply ‘has a form been received?’ It’s foolproof.

They have certainly found a solution. But if you ask them what they thought the problem was in the first place, they get all defensive, like Superman when his mum’s washing his Lycra. Then they bring out the figures from the Business Intelligence Unit (aka their mate Dave) and say, accusingly: ‘Do you know this year cataract operations have gone up by 35%?’

‘OK… Well it seems a bit bizarre that unnecessary cataract ops are being done, since cataracts are a pretty straightforward diagnosis, and anyway presumably a patient wouldn’t agree to have an eye op if they weren’t, in fact, going blind. How do you envisage the PPwT scheme will help?’

‘It may encourage us to raise the threshold criteria of visual acuity before a patient is allowed to have to get an op.’

‘That’s a bit short sighted isn’t it?’ Another GP is already on the phone to her husband asking for private healthcare insurance for her brithday. ‘I mean, could it be that cataract ops could have gone up by 35% this year simply because the hospitals are getting more efficient and doing more ops in the same period of time?’

‘Yes.’

‘Well that’s good isn’t it?’

‘No. We can’t afford it. So we need to slow down services and increase waiting times.’

‘Ok, well that’s a bit hard to do when patients can see which hospital on Choose and Book has the shortest waiting time.’

‘True.’ One of them scribbles down something that looks like ‘Rig Choose and Book’. ‘Anyway, now we need some feedback. How would you like this data to be presented next time?’

‘As a roll of Andrex?’

On this, everyone agrees.