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Gold, incentives and meh

Tale-telling will lead to malice and suspicion

I'm writing about the plans for colleagues and staff to assess GP performance.

GPs have nothing to fear, according to Professor Mike Pringle. And I would not fear it, except for the colossal waste of time and energy involved, not to mention the potential for malice and suspicion.

There is a precedent for such activity in the German Democratic Republic. It was so successful that the country was obliged to erect a wall to stop the population from leaving.

The primary care team includes receptionists as well as nurses and doctors. To encourage tale-telling is to undermine its effectiveness to the detriment of patient care. Decent staff will be embarrassed at being asked to contribute to such a process, especially if they know it has teeth.

Remember, they probably have to go on working with the individuals involved.

This is a bad and unnecessary idea. There is no evidence that Shipman's practice staff would have shopped him.

Referral and prescribing data should be used to identify GPs whose clinical practice could bear further scrutiny. In Northern Ireland, we have had a comparison of practice death rates, which has shown a number of 'unusual' practices. So far, unsurprisingly, we have found these anomalies to be linked to the effects of social class and the presence of care homes.

Dr Lewis Miller, Belfast

We have been hearing so much about how to find out how a GP performs.

The authority that decides whether a GP remains fit to practise ought to be the same one that decided in the first place that they were fit to become a GP.

It may be right to ask patients to rate GPs, but it is not right to ask practice staff to rate their employer. This idea seems like April madness.

Perhaps the Government believes we should be asking the delivery man to the surgery his opinion too?

What more is to be achieved by asking practice staff their opinions that has not been achieved already by means of data collection?

Dr S N Patnaik, Sunderland

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