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Johnson's singlehander slur ignores patients' views

Alan Johnson has no idea what he is talking about.

I took over a singlehanded practice from a friend who retired last year, running it with two salaried doctors to cope with the workload, and I have found patients prefer singlehanded practice.

They value the personal relationship with their doctor and the consistency of care they get above anything else.

The changes to general practice over the past five years make singlehanded practice virtually impossible, but that does not mean small is no longer beautiful. My partners and I in my main practice run services for 20,000 patients. We could have crammed them all into a Darzi centre, with our 12 doctors working a shift system.

But this is not what patients want. Instead we have four small local units with specific teams at each site preserving a local service.

Our QOF scores have improved year on year to now reach the maximum possible and our satisfaction surveys are similarly rising. But I have to admit that nowhere can we get near the satisfaction levels of over 95% on all parameters obtained by our recently retired singlehanded colleague.

Dr John Orchard, Alfreston, Derbyshire

I find Alan Johnson's comments at the unveiling of the Hillside Bridge health centre in Bradford offensive.

He predicts the demise of solo GPs, some of whom he says aren't meeting the standards expected in 1948 - but I suggest he checks his statistics. According to the patient questionnaire performed by CFEP for the NHS, small practices (those with a list size smaller than 3,000) outperform on patient satisfaction all other practices (those with list sizes above 3,000).

In my own PCT - Tameside and Glossop - singlehanded and small practices also score among the highest in the QOF. It is my impression that it is the larger, all-singing, all-dancing practices that score worst.

Dr Ian Maclure, Mossley, Greater Manchester

It hurts me to find that Mr Johnson has such a poor opinion of singlehanded practices.

I was a singlehanded GP in an inner-city area until I retired, and I still do locum work for such practices.

Without singlehanded practices in inner-city areas there would not be any healthcare for our deprived populations.

Many of these practices were started by overseas-qualified doctors, who often have better postgraduate qualifications in various specialties than the average GP and are assiduous in attending CME programmes for their professional development.

Mr Johnson is indirectly targeting overseas-qualified GPs with his comments and this amounts to little more than institutional racism.

Dr S Venugopal, Birmingham

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