Letter: Health bosses 'vital for care'

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Sir: Patricia Wynn Davies' article ('Managers in family doctor practices rise by 41 per cent', 3 August) reporting Dawn Primarolo's comments on managers in primary care shows a lack of understanding of the health service on the part of Ms Primarolo and is insulting to the vast majority of practice managers in this country.

The rise in the number of practice managers has nothing to do with the Department of Health or Mrs Bottomley. General practitioners are independent contractors and can choose whom they employ. That they have chosen to employ managers (80 per cent of whom are women and 50 per cent from a clinical background) shows that perhaps GPs take primary care more seriously than the Labour Party which has failed yet to put forward any convincing alternative arrangements.

Primary care has become more complex since the introduction of fundholding. According to our recent survey of practice managers, many are managing organisations worth more than pounds 3m. Such organisations need high- quality managers. If Labour does come to power, it too will discover that good management is an essential ingredient of high- quality health care, especially during periods of major change.

Yours faithfully,



Institute of Health Services Management

London, NW1

3 August