Letters: Becoming a GP is not an ‘easier’ option

Saving general practice

Sir: Regarding J. Meirion Thomas’s article (‘Medical emergency’, 4 June), traditional general practice continues to thrive in private medicine. For a 20-minute consultation costing £80, a patient can still get a rapid face-to-face appointment. I believe historians will record that NHS general practice reached its zenith in the mid-1990s when John Major was PM and most patients phoned their GP before calling an ambulance. The rot set in under Tony Blair, when he abolished ‘fund-holding’ (a good example of levelling-down) and we lost control of waiting lists and many ‘in-house’ services such as physiotherapy, counselling and minor surgery. The end came under Gordon Brown and the new contract, so that few GPs now provide end-of-life/palliative care, obstetrics and emergency treatment. If general practice is to recover within the NHS, we must look at a European model where the pay system encourages doctors to practise medicine and gives patients the power to choose whom they wish to see and when.

John O’Sullivan (retired GP)

Hursley, Winchester

What’s up, doc?

Sir: J. Meirion Thomas may be correct that general practice needs reform but he is wrong to question why GPs suffer from burnout when their work is ‘less complicated’ than that of hospital doctors. A GP has to deal with a static population, many of whom are economically disadvantaged, psychologically frail, chronically unwell and elderly. Not to mention the chronic complainers and addicts. The GP has to be social worker and counsellor while still meeting government targets.

In hospitals, particularly in surgical practice, patients present defined problems with definite solutions and the carousel moves on. In 30 years of vascular surgery, I never had a problem with ‘life and death decisions’ and indeed would have done the job for half the salary; no amount of money would have compensated for the quotidian demands of general practice.

A living collection

Sir: I write as a former surveyor of the Queen’s pictures (1988-2005) to contest the view expressed by Jack Wakefield (Arts, 4 June) that the royal collection has become an anachronism.