You wouldn’t treat a dog like a GP’S patient under the National Health

sir – On Wednesday morning I noticed a lump on my dog’s leg. I called the vet and was given an appointment for four that afternoon. A biopsy was taken and I was left £80 poorer.

Contrast this situation with that of a member of my family, who has been afflicted by a painful rash under her arm that has not responded to pharmacist-advised topical treatment. The first available appointment with our GP is in two weeks’ time.

Given the option, I would happily pay for the kind of service my dogs enjoy. Kirsty Blunt

Sedgeford, Norfolk

sir – The average day in general practice far exceeds what is generally considered “full time” (“GP contracts let patients down”, Leading Article, August 17).

Our members report routinely working days of 12-plus hours consulting patients. That’s before they’ve started tackling the evermounting pile of administrative work that is an inevitable companion to modern medicine.

A recent “routine” day of my own in clinic last week involved seeing 32 patients face-to-face, speaking to another 14 on the phone, then interpreting and acting on more than 80 blood test results and 38 scanned letters. I’ve had several junior colleagues saying to me that after a full day working at this pace, they just can’t think straight the next day.

Working under these conditions long-term is simply not acceptable for our trainees, or for existing GPS trying to support those new to the profession – and it isn’t safe for patients.

Your editorial recognises that general practice is the gateway to the rest of the NHS. We make the vast majority of patient contacts and thus alleviate pressures across the health service, keeping it cost-effective. If general practice crumbles, the rest of the NHS will not be far behind. Professor Helen Stokes-lampard

Chairman, Royal College of GPS London NW1 sir – The care scheme developed in Sandwell (report, August 13), where people with long-term diseases can get advice from a medical team over the phone or arrange a house visit, bypassing their GP, is further evidence that general practice as we have known it is withering on the vine.

The current generation of doctors does not want to join a traditional partnership. People also have access to a wealth of alternative sources of advice or care online.

There needs to be a strategic plan to set up a national service for primary care, based on a network of modern health centres or attached to local hospitals. Integration with specialist care would be easier and in certain circumstances the public might well have direct access to specialists.

GPS should be invited to join this new service as salaried employees. Investing billions in order to employ more GPS to join a creaking 1948 model is not the way forward. Dr Robert Walker

Workington, Cumbria