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At the heart of general practice since 1960

Non-conformist GPs advance profession

Why does Dr Alistair Scotland, medical director of the National Clinical Assessment Authority, feel the top 2.5 per cent of doctors should be kept an eye on, and based on what criteria?

What message is Dr Scotland trying to convey? That all GPs should conform to a mundane, approved formula? The threat being proffered may stifle all innovation and development within primary care if it is implemented.

It may allow PCOs to keep to their budgets, but it certainly will not encourage GPs to think 'outside of the box' or challenge outdated practices. What similarly happened to the ethos of 'whistleblowing'? Knowing that the PCO has the ability to cause considerable upset by referral is certainly going to threaten that idea.

I agree with Dr Robin Jackson: 'High-flyers difficult to manage? ­ I hope I'm one of those GPs' (July 21). I have never been easy to manage but nor have I required intensive management. I am proud to be an innovationalist who challenges current practices.

It is only by so doing that our profession advances. I know I may not always be right but I have a right to stand up and question what is happening within my PCO, my practice and the health economy at large.

Dr Andrew Dayani

Taunton, Somerset

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