Right of Reply: John Chisholm

The chairman of the BMA's committee on general practice replies to Jeremy Laurance's article
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The Independent Culture
JEREMY LAURANCE correctly states that if the personal link between patient and family doctor is broken, a pillar of the NHS will be lost ("Say goodbye to your local GP?" 28 April).

He is not right, however, to imply that patients all over the country are having to wait weeks to see their GP. Where delays of up to two weeks occur, they sadly reflect a chronic shortage of GPs, predominantly in deprived areas.

Constantly increasing GP workload (consultations have nearly doubled since 1975) means it is not always possible to offer same-day appointments for non-urgent matters.

Even so, the recent government survey of more than 61,000 people found that four out of every five patients thought their appointment was as soon as necessary. GPs are working flat out to meet their patients' needs.

All GPs provide out-of-hours emergency care either personally, or via GP co-operatives or deputising services. It is wrong to blame GPs for the crisis last Christmas - more than 20,000 GPs work in co-operatives alone, giving out-of-hours emergency care.

It is far too early to tell what impact NHS Direct - the nurse-led telephone advice system - will have on primary and secondary care. GPs will not allow it to "spell the end of the traditional GP", and we are working to make sure that both NHS Direct and the proposed Walk In Centres are add-on services, not inadequate replacements.

The UK is rightly proud of its health service. The GP practice is the cornerstone, and the cost-effectiveness of British general practice is envied elsewhere.

Anything which threatens that, threatens the NHS itself. GPs are here to stay.