Letter: Tomlinson's effect on casualties, mental health and community care

Sir: I have been saddened by the knee-jerk reactions of people to the Tomlinson report. I am a GP in south-east London and know that health care in London cannot carry on the way that it has been with long waiting lists and, until this report, very little concern for the needs of local populations.

The focus of care must be the services provided and not the historical buildings it has been delivered from. These buildings, full of empty beds, are costing Londoners huge amounts of money and this will continue to limit the services they receive unless some closures and integration occur, as set out in the report.

This report has not been produced by a right-wing think tank, but largely by the King's Fund. It has tried to set out a better way to provide health care in the capital by building up primary care, which has never developed easily in the shadow of established teaching hospitals. This can only be done by putting money into primary care before closing secondary care units, and fighting to ensure that it is properly resourced. It is not a way for the Government to save money.

Many GPs in London need help to develop. This is a golden opportunity to focus care at a community level, not leave it based on the very large secondary care units. Patients should be treated as members of their communities who are temporarily 'lent' to hospitals for such care as and when the need arises. Responsibility for this should rest with primary care.

It is ironic that such strong supporters of communities as the miners should be linked to opposition to a report that wishes to put more care back into the community. Please allow my colleagues and I the chance to develop a better model for health care in London.

Yours faithfully,

MARC ROWLAND

London, SE23

25 October