Dr Phil Hammond, GP, lecturer and presenter of BBC2's Trust Me, I'm a Doctor

Last week, I met a man called Bill who owns a hotel on the south coast. He was visiting his mother, whoÍd been admitted to hospital after a fall.

ñIt was mayhem on the ward. Overcrowded, everybody shouting and the nurses running round like headless chickens. I was really worried that my Mum wouldnÍt get the care she needed.

ñSo I found out the names of two of the nurses who were supposed to be looking after her and gave them £50 cash each and a voucher for a weekend at the hotel. They were pleased as punch.î

And what effect did it have on his motherÍs care?

ñIt was miraculous. They gave her all the attention she needed. Whenever I came on the ward, there they were, round the bedside. Mum says they canÍt do enough for her.î

When I asked Bill about the ethics of what heÍd done, he couldnÍt see the problem.

ñEveryone goes on about how poorly nurses are paid and how we donÍt value them enough. I just wanted to give them a special thank you for looking after my Mum.î

ÅYes, but theyÍd only just started looking after her. Do you not think it might be seen as a bribe? Giving her preferential treatment when other patients might be even more deserving?î

ñLook, when itÍs your Mum lying there in agony, you do whatever you can.î

He had a point, I suppose, if not a fair one. A nurse I spoke to was equally sceptical.

ñWe have a very strict code governing what we can and canÍt accept from patients, and cash is a definite ïnoÍ, although you can make a donation to the ward.î

ñWhat about chocolates?î

ñWhere I work, every single present is supposed to be registered on a list in SisterÍs office so it can be shared out or given back as appropriate.î

ñAnd does everyone register their presents?î

ñOf course we donÍt. If a patient gives me a box of chocolates or a bottle of wine for something IÍve done for them, IÍm blowed if IÍm sharing it with anyone else.î

As a doctor, IÍve happily accepted chocolates and wine from grateful patients. Indeed, the only gift IÍve ever considered refusing was a bottle of Rapport aftershave. Not because of the smell, but it just seemed a bit too intimate. Like accepting a pair of pants or some athleteÍs foot powder.

But IÍve never been given anything substantial. When I worked in Jersey, one of the resident doctors was offered a car by an elderly lady. He accepted it, but only after a test drive and then checking with a psychiatrist that the woman was legally competent to make such a decision.

When I qualified as a doctor, a Bristol GP was left £1.6 million by a grateful patient. This wasnÍt my reason for going into general practice, you understand, and the doctor concerned went far beyond the call of duty, cleaning and shopping for his future benefactor. Needless to say, the local press were dubious when he expressed ïthe greatest surpriseÍ at being left so much money, but IÍm sure he deserved it.

Other doctors refuse even small gifts, usually because theyÍve had a bad experience in the past. A Chocolate Orange every Christmas is fine, but one a week is pushing it.

Some patients get hooked on the idea of bringing a small gift to every consultation – home-made chutney, pressed flowers or denture fixative. You name it, weÍve been offered it.

ItÍs hard to imagine being ïboughtÍ by denture fixative, but most doctors hate the thought of being in debt to someone. So when the patients have left, we donate anything thatÍs a bit dodgy to the receptionistsÍ Christmas lucky dip. ñOooh. Rapport aftershave. My favourite.î

  • Dr Phil can be heard in ïStruck Off and DieÍ (Wednesdays Radio 4, 11pm).

Guidelines in Practice, May 2000, Volume 3
© 2001 MGP Ltd
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