Health 'shackles' good for patients: Letter

Sir: The new White Paper which promises to remove the shackles of inflexibility from general practitioners and primary health care ("Back to the future with cottage hospitals", 16 October) would do more harm than good.

It is the present "inflexibility" of the system which maintains the excellent doctor-patient relationship which is the bedrock of primary care. In the present system, general practitioners, besides having a contractual duty towards their patients, also have a moral duty.

Remove these shackles and you will also remove the "morality" which exists within the profession. Let us not forget that legal constraints protect an individual when things go wrong, but moral constraints prevent a mishap occurring in the first place.

Recreating cottage hospitals is not as bright an idea as it seems on paper. Why were district hospitals created? Because the quality of work outside teaching institutions was so patchy and uneven that patients were suffering.

In its headlong rush to "improve" the NHS, a euphemism to reduce costs, the Government is throwing the baby out with the bathwater.

Dr A M GORDHANDAS

Scunthorpe, Humberside