Letter: NHS management in practice

Sir: Being a medical practice manager for the past 11 years, I read with interest the article by Patricia Wynn Davies stating that there has been a rise of 41 per cent in managers employed by family doctors (report, 3 August). May I point out that the majority (if not all) of new managerial appointments by GPs between October 1990 and October 1993 will have been in 'new' fund-holding practices, and therefore the 'new' managers are 'fund managers', not practice managers, as the roles are completely different.

Practice managers usually do not have any involvement with the 'fund', but manage the practice: ie, building, staff, complaints, items of service claims, immunisation and cervical cytology targets and generally take care of the day-to-day running of a medical practice, thus relieving the doctors from the pressures of ever increasing paperwork to concentrate on their patients.

Practice managers have been in post for at least 20 years as the Association of Medical Secretaries and Practice Administrators (Amspar) will confirm.

Yours faithfully,

J. A. APPLEYARD

Bolton, Lancashire