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At the heart of general practice since 1960

We're losing sight of true purpose of GP self-regulation

Many of us are deeply unhappy about the way regulation is going. While we should all be striving towards 'best practice' in the interests of our patients and our professional pride, we are having more and more scrutiny, supervision and audit forced on us, which takes away our time, our energy and our self-esteem.

I have just seen the new draft PMS contract, which is full of such pernickity detail I could spend forever doing unnecessary things (in terms of patient care) in order to comply. It goes to such fine detail as to say prescriptions will be signed with your 'initials and surname, or first name and surname'. This means that my colleague's illegible, though highly distinctive squiggle, would place him in breach of contract.

Surely the time has come for us to refuse to co-operate with these demands. Some of the most useless doctors I have ever worked with would be able to pass the strictest revalidation by sticking to the rules. There is still art and craft in medicine, and in general practice in particular, which doesn't involve fiddling with figures and meeting targets.

We should be fighting attempts to interfere with self-regulation, not giving in. The GMC, in attempting to be more in tune with these demands, is making some very dubious moves. The decision to take Professor Meadows to task for his evidence in child abuse and Munchausens by proxy cases is one example.

It has been said we need to keep public trust and keep public opinion on our side. Public opinion, these days, seems to equate to whatever new frenzy the media has whipped up for the next big headline. The only public opinion I'm interested in is whether or not my patients trust and respect me. The rest I can happily ignore, just as our politicians ignore the strongest expressions of public opinion which are at variance with their plans.

Dr Andrew Hamilton

Unst, Shetland

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