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Perhaps we just got good at treating depression

I would like to point out that practices get the Q&O payment of £75 per point only if they have more than 5,885 patients. If they have fewer, only a proportion of £75 is payable. A practice with 3,000 will be paid £75 x (3,000/5,885).

Our negotiators should look into this. It appears small practices will be suffering financially. However, if a practice has more than 5,885 patients it will be paid a lot higher fee.

It's another way of trying to cut the number of small practices – which provide excellent services and keep patients happier.

I think the Department of Health should learn a lesson from big companies like BT and British Gas, which have divided into small components to give a personal services.

Their unhappy customers leave in droves and go to small companies, which provide a very personal service.

Dr Yogesh Kapur

Holywell, Flintshire

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