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CAMHS won't see you now

Outcomes depend on patients too

I could not agree more with your editorial about MMR distrust (July 14) ­ as I am sure most GPs would. But what amazes me is that by voting for the new contract we have just chosen to extend this undesirable situation to many other areas of our work, where there is a greater possibility of real conflict of interest.

It is all very well to say we can get patients to state

that they refuse our advice, but that puts them in an awkward position and in practice most settle for a non-confrontational response.

The situation reminds us that to a significant degree outcomes are dependent on patients and not wholly on the quality of our service.

I also believe these targets make an unhealthy shift in responsibility for patients' health from them to us, suggesting that perhaps we do still believe we are God after all.

Can those of us who have no such illusions ­ and are saddened by the new contract ­ get together to develop a response?

Dr Deborah Halsey

London SW16

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