How can the NHS justify record pay rises for GPS who won’t see patients face to face?

SIR – Your report (September 2) on GPS receiving record pay rises during the pandemic sums up everything that is wrong with the NHS.

By refusing to see patients face to face, GPS are effectively on strike and should therefore not be paid at all. It’s another example of increased funding being wasted.

Let’s hope that our new PM has the stomach for root-and-branch reform. Trevor Joyce

Canterbury, Kent

SIR – I cannot remember the last time I, or indeed any member of my family, had a face-to-face appointment with a doctor from our local medical practice.

The only services on offer have been either a telephone consultation or an appointment with a nurse, which, on each occasion in my case, led to wrong diagnoses incurring considerable expenses in prescription charges.

It is incredible that GPS can receive a reported 17 per cent salary increase, with many working only three days a week while patient demand is increasing.

Chris Learmont-hughes

Caldy, Wirral

SIR – The generous average salary of GPS perhaps explains the fact that so many practices now have part-time doctors. There appear to be few surgeries where doctors work a five-day week, which then makes it difficult to have follow-up appointments with the same GP.

Locum doctors are employed and they have no personal rapport with the patient. Many people may delay going to the doctor because they no longer know the person they will see.

Alison Petley

Shipston-on-stour, Warwickshire

SIR – André Gide wrote that “man’s happiness lies not in freedom but in the acceptance of a duty”. A large salary does not necessarily produce more working practitioners.

I am a retired GP. General practice is the bedrock of our NHS and I believe that until all patients again have a named, happy GP who accepts their responsibility, it will struggle. Adrian Davis

St Mary’s, Isles of Scilly

SIR – I voted against the 2004 GP contract, but none the less it was clear that 24-hour responsibility simply could not continue (J Meirion Thomas, “NHS general practice has passed the point of no return”, Comment, September 1).

The day job had changed so much, with growing demand and expectations. I well remember working a whole day and through the night, having to return the next day to cover the surgery. This was neither safe nor healthy.

The fundamental issue in 2004 was that the Department of Health massively underestimated the true cost of providing out-of-hours care. GPS had effectively been doing it for free for a very long time.

Mr Meirion Thomas argues that the independent contractor status should be challenged. To some extent, I agree. There are some very successful, popular partnerships and others are sadly failing. I work four long days each week in a very busy, thriving partnership, doing many hours that are effectively unpaid. So, if 40 hours a week is considered average, who would do these extra hours and how would they be paid, were we all to be employed?

Finally, continuity of care really does make sense, especially for our elderly patients with many health concerns. When I started in 1995 the average GP list was roughly 1,700 with a consultation rate of two to three per patient per year. Today my list is 2,500 with an average of six to eight consultations per patient per year. You don’t need a degree in maths to see that ensuring continuity of care can be difficult to achieve. Luckily, we have been able to recruit new GPS.

I wholly believe in the idea of the NHS being free at the point of use. However, it is no longer 1947 and society has changed. My rose-tinted spectacles have become a disability; expectations have increased exponentially and I fear the NHS as we know it will not cope in the future.

Dr Richard Loach

Seaview, Isle of wight