Phone consultations mean stressed GPs and dissatisfied patients


SIR – In 1993, I joined a practice of two general practitioners providing all primary care to 3,600 patients with the help of two receptionists. The average patient came four times a year. Today, two general practitioners lead a team of 30 highly qualified staff who care for 4,800 patients. The average patient visits nine times a year.

We no longer refer everyone with blood pressure issues, asthma, diabetes, chronic kidney disease, high cholesterol, etc. We diagnose and manage them internally.

Seeing that the country could not fill all the gaps by training more general practitioners, the government introduced clinical pharmacists, primary care mental health practitioners, first contact physiotherapists, even friends, and many other roles. auxiliaries to help general practitioners. This is called the skill mix. These professionals assess, investigate, prescribe, refer and treat in their own specialties better than I do.

Politicians must therefore stop telling patients to demand face-to-face doctor appointments and advise them to engage with receptionists and be referred to the right member of the broader primary care team. .

Dr Ken Leeper
Billinghay, Lincolnshire

Reform of the Royal Marines

SIR – All of us in the Royal Navy community have been shocked and saddened by the untimely death of Major-General Matt Holmes (report, October 13), especially those of us who have served closely alongside the Royal Marines in peace and war.

In light of the circumstances of his death, it was a shame that the reports included hints of an alleged split in the naval service earlier this year over the introduction of reforms in the naval command, which will make the navy capable of competing with confidence and efficiency in the 21st century.

These reforms included, following their distinguished service on land in Afghanistan and Iraq, the Royal Marines, which, in accordance with the recent integrated government review, were to revive and expand their specialized commando role as the primary system of weapon and assault our amphibious and coastal combat ships. Matt was a committed supporter of this Future Commando Force initiative, which is enthusiastically championed by the current generation of Royal Marines.

It is therefore unfortunate that some retired senior Royal Marines officers, for personal or regressive reasons, have sought to take the opportunity of Matt Holmes’ death to turn back the clock and provoke an unnecessary and spurious argument within the Royal Navy.

Rear Admiral Dr Chris Parry
Commander, Amphibious Task Force, 2004-2005
Portsmouth, Hampshire

Thank you rail courier

SIR – A while ago I lost my camera at Canterbury West station.

I was going back to Maidstone and had to change in Ashford. I mentioned my loss to a member of the station staff (Letters, October 14). The same day, I received a call telling me that the camera would be waiting for me to pick up at Maidstone station.

I wrote a thank you letter to Ashford station and received a response thanking me for my letter, which was now on the staff notice board as they received so few.

Margot Drury
Warmsworth, South Yorkshire

SIR – At the end of a train journey, my maternal grandmother got out of the car and went to the front of the train to personally thank the driver of the steam engine.

Richard Huntley
Dinas Powys, Glamorgan


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