I first started writing this column in The Practitioner an astonishing 25 years ago this month. In the words of one of my favourite songs, ‘Who knows where the time goes?’

A quarter of a century ago, general practice and the NHS were very different. Scotland and Wales had not yet taken on devolved responsibility for healthcare.

NHS Direct and NHS 111 had not yet been born. Two-week cancer waiting time targets did not exist, but GP fundholding did.

The political leadership of the NHS has changed significantly over those 25 years. We’ve had many different Secretaries of State for Health, from Stephen Dorrell through to Matt Hancock. I once calculated that in my career as a GP, there were 16 different Secretaries of State. I was pretty certain that my patients didn’t notice any of them until the advent of the pandemic when Matt Hancock started to appear almost daily on our TV screens.

A mere ten years ago, I wrote that I had steadfastly ignored every single service development that had come along when choosing what I should write about. Whether it has been fundholding, total purchasing, practice-based commissioning, the role of the Executive Council, Health Authority, FHSA, PCG, PCT etc, I have ignored the lot.

This is mainly because what has gone on in my consulting room has been resolutely unaffected by what has gone on in Whitehall and the world of management.

Indeed, my very first column for The Practitioner, back in 1996, focused on perceptions of risk, something that is every bit as relevant today.

While the current pandemic has inevitably had a profound effect on the way that GPs have to practise, the simple fact is that human beings change remarkably little. The emotions described by William Shakespeare, 400 years ago, are all totally recognisable today, in a very different world.

The simple fact is that however fast the times may change patients change remarkably little.

Over the decades, indeed over the centuries, in that extraordinary intimate exchange between doctor and patient, patients have continued to consult family doctors. They have shared their stories, their hopes, their fears, and the remarkable complexity of the average human life. Despite masks, COVID-19, and the passing of the years, human nature hardly changes at all.

My 25 years is but a fraction of The Practitioner’s long and distinguished 153 year life. My father, who was also a GP, died as far back as 1964, but I recall his shelves packed with back issues. The Practitioner looked very different then, but patients and their problems will have been remarkably similar.

It has been a real honour to occupy these back pages for a quarter of a century, but I still need to ask – where does the time go?