Patients are at risk because GPS no longer fulfil the core duties of the job

sir – When I started, general practice was considered the jewel in the crown of the NHS. Now politicians are openly talking about its end and proposing that primary care doctors become salaried NHS employees rather than being trusted to run their own practices as independent contractors. Anybody thinking they will get more out of doctors this way is deluded.

Regrettably, it is Conservative governments that have done the real damage. When general practice was at its absolute best, they utterly failed to value what we were doing. Worse, they imposed a contract based on a bogus theory of competition, and GPS sold their souls in order to control budgets, cream off perks and push around other parts of the service, including our hospital colleagues.

This was followed by increasing numbers of targets, incentives, appraisals and bribes, which had nothing to do with patient care. Even clinical decision making became affected by money. Wes Streeting, the shadow health secretary, is right that general practice finances are “murky”.

The core parts of the job – answering the phone, being available, seeing patients in person, haring out to emergencies, offering continuity and therefore having the affection and trust of your patients (the biggest perk of the lot) – are all less important now. No wonder nobody wants to do it anymore.

So many GPS are opting to work just two or three days a week. Four younger full-time partners in my former practice left the job for good to do other work. What on earth have the British Medical Association and Royal College of General Practitioners been doing all this time?

I am in no doubt that general practice harmed me, but I am now concerned that the lack of it will harm those I love.

Simon Harper

Truro, Cornwall

sir – Before GPS tell patients go to hospital by bus (“Catch a bus to hospital if you suffer a heart attack, say

GPS”, report, January 7), they should check that there is a bus service.

In our village there is no bus service to a hospital, or to anywhere else for that matter.

Jonathan Longstaff

Buxted, East Sussex

sir – Last Thursday I saw my GP for a blood test, an electrocardiogram and a consultation. On Friday at 10am the surgery rang to tell me it had the results of the tests and to pack a bag and go to the Cumberland Infirmary.

I did as I was told and went to the same day emergency care (SDEC) department, where I was expected and given a room, seen by nurses, and had tests, X-rays, an iron infusion and discussions with nurses and specialists. A plan of action was formed to help me get better. Throughout the day I was treated with care, humour, kindness and professionalism.

No fault could be found. I was very lucky. The SDEC system works.

Janet Stukins Wigton, Cumbria