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At the heart of general practice since 1960

CBI has no business attacking GPs

What sort of doctor is Dr Neil Bentley of the CBI (Letters, 31 October)? Not a medical one perhaps?

He laments that the service provided by GPs has hardly changed in the past 60 years, and particularly that GPs still perform a role as ‘gatekeeper' and guide.

I can only presume he is totally unaware of the massive rate of change across clinical practice, epidemiology, service configuration and information technology, and the changes brought in through the GMS contract, working time directive, employee legislation, discrimination legislation, human rights legislation, child protection procedures and so on.

The one function of GPs he picks out for special criticism is one that is widely considered to be the most valuable basic virtue of British-style general practice, envied by the world. Has he not read any of the seminal ‘gatekeeper' papers of the 1970s or 80s?

The gatekeeper role is thought to save millions of pounds annually – not to mention patient harm by inappropriate treatment – by avoiding inappropriate specialist consultation.

It is central to ensuring the efficiency of the NHS, and the CBI should know about efficiency in large businesses.

The CBI should be standing up for British businesses, including GP businesses.

One is left wondering about the possibility of political influence at the heart of the CBI and whether such lack of understanding of the working conditions of constituent businesses should be tolerated in a CBI director.

From Dr David Church, executive director in a business providing general medical services, Machynlleth, Mid Wales

• From Dr Jon Turvil, Cockenzie, East Lothian:

We must all be delighted that Dr Neil Bentley found his way to public services at the CBI when he gave up medicine. His insight into our archaic working practices is remarkable.

Indeed, a colleague reminded me about a woman he saw whose employer had sent her for a sick note because she needed a day off for a cold, leading me to muse about health and safety and loyalty to employees and duty of care and give and take and all those silly old traditions with which old-fashioned employers used to mollycoddle their workers. Thank goodness all that nonsense has been swept away.

Yes, Dr Bentley is quite right – what we need in the NHS is reform, so that our morale can be boosted to a new high. Now... where did I put that paraldehyde?

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