GPS must visit homes

sir – Stopping home visits (Letters, November 12) would be the last nail in the coffin for general practice. There have always been patients who waste doctors’ time, but this is part of the job.

The British Medical Association is prepared to debate the matter, which is not surprising: in 2004 it negotiated a new GP contract with the Labour government that allowed GPS to opt out of evening, night and weekend on-call work. This retrograde step ushered in NHS Direct, and is the main cause of rising visits to A&E.

In England in 2002-2003, 14.05 million people attended A&E and figures had stayed around 14 million annually for the previous 15 years. In 2016-2017, 23.36 million people attended, an increase of 66 per cent. Over the same period, the population rose by 11 per cent and the proportion of over-65s by 13 per cent.

There are ways to reduce GP workload. Abandoning house calls must not be one of them.

Dr Stefan Slater

Edinburgh

sir – Home visits by GPS are a waste of money and time. I spent six months as a GP in northern British Columbia in the Seventies and saw thousands of patients, but only visited two homes.

The reason was the huge distance in travelling to some homes, and the fact that everyone had a car. If a patient became ill out of hours, they phoned the GP, who arranged to meet them at the local hospital. There the patient could be examined and it was easier to make a clinical assessment than in the half-light of a bedroom without an examination couch. If the GP decided the patient was too ill to be at home, they were admitted to hospital.

Michael Lavelle

Scaynes Hill, West Sussex

sir – There is a place for home visits. Once I was called to see a patient who was falling frequently. The local specialist clinic had not been able to help. However, after I replaced a light bulb at the top of the stairs and nailed down the carpet, the falls promptly stopped.

Dr Nick Summerton

Brough, East Yorkshire