Letters: GPs reply to J. Merion Thomas

Some doctors write

Sir: Professor Meirion Thomas (‘Dangerous medicine’, 17 August) may be an excellent surgeon but he is uninformed about the nature of GPs’ work. For many older consultants in the NHS, it will have been decades since they last spent any time in a GP setting, if they have at all.

He fails to realise that 95 per cent of the work of diagnosing, treating and caring for patients takes place within general practice. Common illnesses range from depression, to diabetes, asthma and hypertension, as well as many others. Dr Meirion Thomas’s idea that nurse specialists are the answer betrays his lack of understanding that most patients present to GP as a complex mix of interrelated symptoms and other factors. His views on IT and the lack of training places are helpful, but on those he has facts to back up his opinion.

Please don’t be fooled by his eminence. His is a very small field compared to the large prairie that is the NHS.
Dr David Bartlett
Olney, Bucks

Sir: Our esteemed colleague J. Meirion Thomas ignores the case for generalised medical practice in the community that will serve a population where chronic rather than acute conditions will be to the fore. His opinion that expansion of A&E services are the answer to the woes of the NHS will not serve an ageing population with the dignity they deserve.

While we wholeheartedly agree with his suggestion that we need to train more doctors, these doctors will need to be working in primary care. The economic argument for expansion of general practice (where 90 per cent of patient contact is delivered with 10 per cent of the budget) needs to be understood by the institutions which educate and plan services.