Poor GP practices

SIR – The Care Quality Commission (CQC) report which purports to show that small GP practices perform less well than larger ones (report, September 21) misses the point.

Bad practices reflect bad doctors. Large practices have as many bad GPS within them as smaller ones, but their effect on overall practice performance is obscured: first, because the patients tend to shun these doctors, and secondly, because colleagues close ranks to protect them from criticism.

Small practices are popular because they are local, and there is continuity of care. The CQC report is a call to the regulatory bodies to weed out underperforming doctors. R W Thomson

Egglescliffe, Co Durham