The NHS would appear to be suffering an in-flight emergency. It is locked on auto-pilot. The cabin crew are unsure what to do. A few are close to panic. The nature of the problem is unclear. The causes indeterminate. No one was trained for this.

Cabin crew announcements become more insistent and louder by the minute. The passengers are told to stay in their seats with their seat-belts on. Window shutters remain closed. The drinks trolley stays firmly in its bay.

Disaster looks certain and everyone braces themselves for impact. Every Act of Parliament thar has ever had anything to do with the NHS flashes in front of their very eyes.

Until, that is, the youngest stewardess seizes the microphone from her boss. She pulls no punches as she candidly tells her fellow cabin-dwellers what is happening. ‘Any ideas?’ she asks. ‘Could any patients on board please make themselves known to the crew?’

Speaking to reporters afterwards here is what was recounted. First, some bright spark lifted their window shutter and it appeared the plane was still in one piece. Then they all did and it was clear they had never left the ground. So another who knew a thing or two went forward and helped the captain get the airplane off the ground. They didn’t understand the dials but, my, how they could pull back on that yoke.

A hysterical patient was given water by his neighbour and then sedated. They all agreed to even get rid of the baggage just to make sure the aircraft would lift off before the end of the runway. For they knew everyone’s life depended on it and they all wanted to get to their destination – which they had all chosen. One even had a friend at the other end who talked them down to the airport there.

Having listened to yet another radio discussion of the great and good about the NHS this morning with not a patient in sight….

And having observed last week’s spat between the overly defensive (we all work hard!) Royal College of General Practitioners (RCGP) and the ever so slightly hysterical Patients Association ( are there any solutions to the problems you would like to actually own yourselves?)….

One can’t help but think that we are partly at risk of talking this plane into the ground ourselves. There’s a lot of shouting going on and not a lot of listening. Cockpit communication has broken down. This can only spell doom or the hardest of landings at the very least.

And yet I wait to really hear ‘the system’ ask patients and the public for their help. Not just their views. Or feedback on the non-threatening. But their support in dealing with issues for which they have run out of solutions. And an acceptance that actually for many patients the present can feel no better than boarding a low budget airline.

I am reminded of a recent story about a GP’s Patient Participation Group. It has excelled at improving the decor. It has even had new automatic doors installed. Great! Brilliant! Just imagine how they might help improve doctor-patient dialogue. If only they were involved. But they are not.

Crash positions!