To avoid trouble Dr Grumble is trying not to blog. But it's hard. It's ten past eight. There's a busy day ahead but sometimes something happens that makes you so angry your wrath has to be vented. Dr Grumble has just finished his work in the Call Centre. He has to prioritise referrals and allocate them to the right clinics. While he was there the phone rang. Although it was before 8 o'clock there was a charming girl there to answer it. She was full of how can I help yous and no problems. But there was a problem. As dates were being discussed for the patient's appointment the clerk explained to the patient that the appointment she wanted would not be possible. It was too far ahead. We have targets to meet. Patients have to be seen within a certain time whether they like it or not. There is no patient choice in this whatsoever. Now isn't that just mad?