Tabloid legend speaks of Judge Paul Sacco, of Fort Lupton, Colorado, whose main aim in life is to make the punishment fit the crime. Every three months he rounds up everybody who has been found guilty of violating his town's noise limitations and subjects them to a 60-minute singsong with Barney the Dinosaur. Homeboys who play gangsta rap at thunderous volume are sentenced to sit through sonatas and cantatas.

Repeat offenders get a large dose of Barry Manilow, even though their lawyers quote the Eighth Amendment of the US Constitution, the one outlawing “cruel and unusual punishment”.

Things are different here. There's nothing stopping me from clowning around with my Musak machine to make the background music suit the clinic in progress. Diabetics sing along to Sugar Sugar by the Archies as they wait for their blood tests. The mental health team inject patients to the strains of Black Sabbath's Paranoid and on Tuesdays the midwives rattle through the antenatal lists spurred on by Guns N' Roses' Sweet Child of Mine.

As for individuals who misbehave...if someone expects me to prescribe complementary remedies for him or her on the NHS, I'll make sure that the next time he or she needs an operation the anaesthetic machine is manned by a crystal healer.

Parents who bring their child to the surgery wrapped in layers of crocheted wool “in case he gets a chill” and take up their entire appointment slot undressing him to be examined will spend eternity playing Pass The Parcel and never be the one who wins the prize.

Patients who expect me to deal adequately with five problems in ten minutes will be sent to join a circus. If they master the art of juggling with five flaming petrol-soaked clubs at once, they can expect me to do the same.

Similarly, anyone who spends nine of their ten minutes telling me about their bunion and then plays the “while I'm here” card to broach the subject of their best friend's brain tumour and these funny headaches they've been having will be given a clairvoyant talking parrot. This remarkable bird will correctly predict the result of every horse race and football match, but not until the moment that the betting windows close.

If you go for private health screening and expect the NHS to deal with the fallout, you will be subjected to 20 blood tests, chosen at random, every single day until they are all reported as normal. Statistically, this will never happen, at least not until you develop anaemia as a result of continuing blood loss.

Some patients say that generic medicines don't work for them and insist on brand- name versions of the same drug that cost the NHS a small fortune. They will be followed every time they visit Tesco. Every “value” product they put in their trolley will be replaced by the most expensive brand in the store.

Parents who think I can hear what they're saying when I've got a stethoscope tube in each ear and I'm trying to concentrate on their kid's heart sounds will be forced to communicate through mime and interpretive dance. Those who turn up with their sick child and his six hyperactive siblings will be locked in an office with baboons to see what effect it has on their work performance. This will be their Groundhog Day.

But I've saved the most severe potential punishment till last: those who ignore their doctor's advice about their lifestyle choices might one day suffer the consequences. Heart attack, stroke, tumour. Funnily, there's nothing amusing about that.

Dr Copperfield is a GP in Essex. He also writes for Pulse magazine and pulsetoday.co.uk

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