How the primary care system is sending patients round in circles

SIR – After being told that my hospital’s audiology department no longer had records of my hearing loss, I was informed that I needed another GP referral (Letters, November 22).

I rang my local surgery and was advised of a three-week wait for a telephone appointment if I booked with the receptionist; the wait would be shorter, however, if I booked online. So I did this, using one of the worst systems I have ever encountered, and got an appointment – in a mere two weeks’ time.

Two days before my appointment I received a text message asking me to ring the surgery. After a 15-minute wait, I was told that the doctor was ill, and I would have to go to the back of the queue for a new appointment in another two weeks.

Finally, after a total of four weeks, I had my telephone consultation. It lasted 30 seconds and the doctor agreed to refer me to audiology again. But that wasn’t the end of it: the next week I got a call from the surgery to say it couldn’t refer me until I had seen a nurse practitioner. I am now into my fifth week of waiting for this appointment. Graham Barnes

Peterborough

SIR – The collapse in general practice as a service has little to do with contracts (Letters, November 22) and everything to do with the loss of the doctor-patient relationship – on which much of medicine depends – and the elevation of GPS to “consultants in the community”.

Since the arrival of larger practices in the name of efficiency, patients are rarely seen by the same GP. Meanwhile, “guidelines” remove GPS’ control over their patients’ treatment. As an occasional patient myself, I find the care element of the consultation is further undermined by the GP’S fixation on a computer, rather than me.

Because of the loss of this personal relationship, the patient is suspicious of the GP. If you do not believe this, consider how you have reacted when told, for example, that you or your child do not need antibiotics. If you trusted the GP’S judgment, why argue? Might it be that you suspect your GP is seeking the approval of the NHS, rather than listening to your concerns? Dr Steven R Hopkins

Scunthorpe, Lincolnshire

SIR – I notice that the Care Quality Commission has decided that 96 per cent of GP practices are “good” or “outstanding”. How can this complacent assessment accord with the experiences of patients?

The CQC deals with process rather than clinical excellence. I never met an inspector when I was a GP.

Dr Peter Hard

Pulborough, West Sussex

SIR – You report (November 21) that NHS England bureaucracy could be slashed. This is welcome – but we have been here before. It ended with large redundancy payments and a round of musical chairs as new (and similar) posts were found in nearby hospitals. Dr Andrew Dyson