Letter: Pressures on doctors to 'cherry-pick' patients

Sir: I agree that expulsion is a crude instrument for modifying patient demand ('Cherry picking fails the 'difficult' ', 11 July) but what alternative do you propose? Unfortunately, in our consumerist society, the free NHS is an anachronism. A service without a price, it seems, is no longer valued.

GPs face rising patient expectation in the form of increasing consultation rates, out-of-hours visit requests, violence and complaints. They cannot complain about their patients and are not paid extra for increased workload. Their only sanction against unreasonable demand, sparingly used, is to remove patients from their list.

Once again, doctors are accused of 'feeling for their wallets' when in fact they are committed to preserving equitable access to high quality services, free at the point of delivery. Unless demand can be modified in some way, GPs will eventually be unable to cope and I fear we shall lose a precious national institution.

Yours sincerely,

IAN TRIMBLE

Sherwood Health Centre

Nottingham

11 July