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CAMHS won't see you now

I just don't understand how polyclinic figures add up

I understand that PCTs, often against their better judgment, are being forced to each set up a polyclinic for 6,000 registered patients including a walk-in centre.

They will operate from 8am to 8pm, seven days a week. What I don't understand is how you cover those hours for such small numbers of patients without draining the local health economy.

We also are shifting resources from the sick and elderly to the fit and wealthy, who will benefit most from polyclinics.

What will happen to continuity of care and GPs' gatekeeper role, which have always been the core of British general practice?

The RCGP, GMC and medical defence bodies seem mute about the major risk to quality and the costs of dealing with complaints and litigation from patients who are seen by a succession of doctors in the absence of continuity.

Where is the evidence of benefit to patients or the public purse in all this?

GPs should be practising evidence-based medicine. So should the Government.

Dr Ron White, Peacehaven, East Sussex

Your move, GP leaders

Anyone who plays chess is used to planning several moves ahead. Surely as GPs we can think in the same way to expose the Government's game.

If one considers the Government's approach, one has to be sceptical of its intentions.

Initially ministers demanded that patients became the responsibility of a practice. This was the first step in depersonalising the service.

Next we have polyclinics, almost Orwellian in concept, which will further destroy the patient-doctor relationship.

We are aware of the next steps - the purchase of practices and polyclinics by big chains - Virgin, Asda, Sainsbury's and so on - and indeed by some leading GPs who perhaps think more about their 30 pieces of silver than their colleagues.

This will be the start of salaried employment for our profession.

Finally, this will lead to the imposition of excessive workload, in an office-based environment, at the behest of our profit-orientated bosses.

We will have entered the divide-and-conquer stage, in which GPs will be fearful of saying boo for fear of losing their jobs.

Then we can all thank our professional representatives for their inability to understand the basic rules of chess. The Government wants to erode our independent status and relationship with our patients.

By the time our leaders react, it will be checkmate.

Dr Michael Kemp, Omagh, Northern Ireland

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