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I question my sanity at putting up with premises problems

I read the article on the future of general Practice by Dr John Couch (Feature, June 14) and felt very thankful I am close to the end of my medical career rather than at the beginning.

I can well remember that one of my motivations for entering general practice was the major difference from the hospital environment. I can see very little difference between Dr Couch's vision and the hospital environment I chose to avoid.

I have practised successfully as a singlehanded GP for some 15 years – and nearly 30 in general practice. I have coped with reorganisations, fundholding and PMS, and appear to be coping well with the new contract, hoping to achieve nearly 1,000 points – this despite the lack of economies of scale factor, which was removed by the Government from the Blue Book.

However, Dr Couch's vision is one leap too far: the whole message was to me summed up by the one missing word in the whole article – 'patient'.

I feel an organisation promoted in the way this has been, and which does not put the patient first, is doomed to failure and to further decline in patient trust in their doctors, and a widening of the demoralisation of general practice rather than an improvement.

I trust I do not work to see these changes happen.

Dr Ian Dimery



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