WHY SO MANY GP SURGERIES ARE FAILING TO SERVE THE NEEDS OF THEIR PATIENTS
SIR – J Meirion Thomas hits the nail on the head (“GPs are putting themselves out of business”, Comment, September 9). He would be appalled – just as I, a retired GP, am embarrassed – to see patients queueing before 7.30 am at my local practice in the slender hope of securing an appointment when the doors open at 8 am.
Online bookings offer no greater hope. Last Friday, at 8.01 am, I was asked to try again at 8 am on Monday.
Part-time doctors are one of the problems in primary care. Even worse, however, is the situation whereby GPs are employed on a full-time basis but only see patients three days a week, with the rest of their time taken up by various forms of administration.
Considering that few home visits now take place, and no night calls, I can’t help feeling sceptical about the Royal College of GPs’ claims of overwhelming demands being placed on its members, along with the idea that thousands more GPs are required before the situation improves.
What is really needed is for GPs to justify their comfortable salaries by being personally available to their patients during their contracted hours.
Dr A C E Stacey MRCGP
Rustington, West Sussex
SIR – Dr Sharon Kleinberg (Letters, September 12) obviously enjoys her work as a GP.
But what of all the people who cannot get an appointment? When I was in practice, it was common to see “extra” patients at the end of a list, but this is no longer the case. Rigid booking systems do not allow for unexpected illness. Yet much of the satisfaction of practising medicine was in helping those “extras”.
Nigel Legg FRCS
Norwich
SIR – It is gratifying to know that Dr Sharon Kleinberg manages to gain satisfaction from being a GP in a broken NHS. As a retired GP (and now a patient like any other), and realising that things are very different these days, I would be interested to know how long the patients she mentions had to wait for their appointments.
As Dr Stefan Slater says (Letters, September 11), “an overhaul is needed”.
Dr Peter Strangeways
Sutton Veny, Wiltshire
SIR – J Meirion Thomas and Dr Stefan Slater suggest that one of the reasons for the difficulties facing modern general practice is the large number of GPs working part-time. They do not mention that many secondary-care doctors also do this.
As a GP who, at the age of 60, has moved from working five days a week to two (rather than retiring completely, as many of my peers and predecessors have), I would argue that part-time working is part of the solution rather than the problem. There are creative ways in which continuity of care can be maintained, such as through buddy systems or teams.
It is also worth noting that at least one of my “non-working days” is spent on practice administration, emails, meetings and continuous professional development. I don’t know how else it could all be fitted in sustainably.
Finally, I am not against extending the training time for GPs, as Mr Meirion Thomas proposes, but there is barely enough capacity in terms of training spaces or finance to serve the current programme.
Dr Mark Harrison
Thornbury, Gloucestershire
Starmer’s ‘process’
SIR – There is a common thread running through the resignations and sackings from this Government.
It was perfectly highlighted in Prime Minister’s Questions on Wednesday. Defending his approach to the situation with Peter Mandelson (before he was sacked the following day), Sir Keir Starmer insisted that proper procedures were followed.
This is the classic defence of the “lanyardocracy”. While proper process is crucial, it is no substitute for judgment. Leadership is about the latter. We are sore in need of it.
Professor Stephen Morgan
Warminster, Wiltshire
SIR – The Prime Minister has made three serious errors.
First, he supported his erstwhile deputy Angela Rayner unequivocally, apparently without fully apprising himself of her financial arrangements.
Secondly, he appointed Peter Mandelson as US ambassador, despite knowing about his relationship with Jeffrey Epstein.
Thirdly, he has not yet resigned as Prime Minister.
David Hemingway
Leicester
SIR – Everybody knew about Peter Mandelson’s links with Jeffrey Epstein. He was appointed US ambassador because he was the best candidate, and he was doing an excellent job.
Donald Trump presumably valued Britain’s refusal to be influenced by Lord Mandelson’s past association with a man who, after all, brought many innocent celebrities into his network. It is a pity that a valuable president-ambassador relationship has been lost.
Pascal Ricketts
London SW1
SIR – Sir Keir has confirmed that he still has confidence in his chief of staff, Morgan McSweeney (“Morgan McSweeney pushed for Mandelson to be made ambassador”, telegraph.co.uk, September 12). I fear for Mr McSweeney.
Roger Cousins
Beaconsfield, Buckinghamshire
Assisted dying dangers
SIR – Life is precious. Professional experience of caring for elderly, disabled and dying patients has impressed on me their vulnerability to the false compassion of assisted suicide (report, September 12).
It must never become part of the skill-set of health professionals: it undermines palliative care principles, exerts pressure on patients and endangers trust.
Patients look to their carers to affirm their lives, not offer them death as a cheap and easy option. Why, when palliative care is more effective than ever before, do we need to consider a dangerous new law?
Teresa Lynch
London W6
Farage’s promises
SIR – Tim Pope (Letters, September 12) discusses Reform UK’s idea of appointing people with “proven expertise”, rather than MPs, to run Whitehall departments, implying that this will magically solve Britain’s many deep-seated structural problems.
Alas, I fear he has fallen under the spell of Nigel Farage. We have unaffordable, unfunded state and public-sector pensions; a welfare system that rewards idleness; an unsustainable free-at-the point of use health service; endemic low productivity; record high taxes and debt; an education system that intentionally masks poor performance; unaccountable and extravagant local government; and planning rules that artificially inflate property prices.
Leadership is telling people what they need to know but wish not to hear. Mr Farage has been no more inclined to do this than any other politician since Margaret Thatcher.
Philip Duly
Haslemere, Surrey
Butterfly bonanza
SIR – I, too, was surprised to learn that Butterfly Conservation’s nationwide survey had reported disappointing numbers (Letters, September 12).
I have never seen as many butterflies, either in my garden or the wider area, as I did this summer. Just last week I counted more than 30 red admirals on a sedum plant, all feeding at one time.
Perhaps numbers vary from region to region.
Jean Kedar
Strathaven, Lanarkshire
Chores for all
SIR – Catherine Pepinster (Comment, September 11) discusses how fewer children are doing household chores.
I come from a family of seven girls and two boys. My father worked 12 hours a day, seven days a week, to provide us with a comfortable lifestyle. This left my mother to deal with nine children and dish out the discipline.
We were each given a daily chore to do before school, such as cleaning the fire grate and setting a new fire, washing the breakfast dishes, making the beds or pegging out the washing. These jobs were on a rota basis.
On returning home for lunch on school days, we were tasked with peeling potatoes and vegetables for the evening meal, feeding the dog and cleaning his dishes, or filling the coal bucket.
At weekends, we were each given a room to clean from top to bottom, while my mother washed all the bed sheets. Some of us were then commandeered to hang them out on half a dozen washing lines. Fresh beds had to be made for 11 before lunch.
The rooms we cleaned were always inspected by mother, who pointed out anything we had missed. While this was going on, she had a hearty casserole in the oven ready for us to eat at the dining table, with a tablecloth, at 12 noon. With all jobs done, we then had the rest of the weekend to read, play, enjoy hobbies or do homework.
Today, we are proud to be upstanding citizens and a credit to our late parents, who taught us how to conduct ourselves, cook, and keep a clean and tidy house.
Sylvia Jones
Manley, Cheshire
No half measures
SIR – William T Nuttall’s letter (“Pub puritan”, September 9) reminded me of our local in the 1970s, which was at the end of our unmade road in Horsell, Surrey. Called the Plough, it was run by a true, old-fashioned publican.
The bitter was kept in tapped barrels in the cellar, and he would disappear down the steps to pour pints for his customers. My wife once asked for half a pint, to which he replied: “If you think I am going down there for a half, you are sadly mistaken.”
No offence was taken.
Brian Earle
Lytchett Matravers, Dorset
SIR – John H Lowe’s description of a Yorkshire pub (Letters, September 11) reminded me of when we moved to North Yorkshire nearly 25 years ago.
Like Mr Lowe, we went to a tiny pub in the Dales for refreshment after a walk. My husband commented on how delicious he found the local ale, to which the landlord replied: “Aye – it’s the best thing to come out o’ Skipton.” After a short pause, he added: “Uther th’n t’road.” I wonder whether it was the same pub.
Jane Sidders
Crayke, North Yorkshire
A master of the modern English novel
SIR – While many would agree with Philip Maynard (Letters, September 9) that Vasily Grossman’s Life and Fate is a great 20th-century novel, it was, of course, written in Russian.
For a great 20th-century novel in English, I would suggest James Joyce’s Ulysses on the grounds of its literary versatility and sheer depth of allusion. “It will keep the professors busy for centuries,” as Joyce himself put it.
However, for the greatest 20th-century novel by an English author, there can be few to rival A Dance to the Music of Time by Anthony Powell. Its 12 volumes cover a period of 40 years in the lives of a set of people, through peace and war. It is full of sublime observation, erudition and deep characterisation. I have just finished reading the whole opus, and feel as if any one of the figures in it could walk through the door.
Dr Rob Caird
Greywell, Hampshire
SIR – War and Peace and Gone with the Wind are great favourites of mine. I have read both numerous times.
Patricia Essex
Hegde End, Hampshire
SIR – No collection of “great war stories” (Letters, September 12) can possibly be complete if it does not include Guy de Maupassant’s Boule de Suif.
Set against the backdrop of the Franco-Prussian War of 1870-1, this short story sheds more light on the cold evil of hypocrisy than any novel I have ever read has succeeded in doing.
Bilal Haider Junejo
Durham
SIR – Any list of great war novels that does not include Catch-22 is, in my view, incomplete.
Michael McDermott
Stratford-upon-Avon, Warwickshire
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2025-09-12T20:06:01Z
