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Gold, incentives and meh

Very few patients really can't get to the surgery

I wholeheartedly agree with Dr Keli Thorsteinsson (Letters, September 15)about the need for a change of attitudetowards home visits. Home visits are a frustratinganachronism dating back to a time when GPs had far less paperwork to do during the day, when 'theDoctor' was likely to be the only one with a car and when the traffic was nowhere near as bad as it is these days.

The vast majority of visits are completely unnecessary and in most cases would be far more appropriately dealt with at the surgery. Home visiting these days shouldbe confined to the terminally ill and those who cannot be easily transported to the surgery, such as patients on oxygen therapy without a portable supply.

Being 'too ill' to travel is not an adequate reason for a home visit. Someone who really is too ill should probably be admitted directly to hospital.

The state of being'housebound'is pathological and should not be encouraged; a trip up to the surgery for such patientsis likely to be beneficialto their psychological and physical well-being.Maybe PCTs could look at providingtransport forpatientswho say they have no transport ­ most can often manage a trip to the hairdresser orsupermarket.

Dr Margaret Lupton


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