Letters: The crisis in general practice can only be solved by listening to doctors’ concerns

A GP takes a patient's blood pressure
A GP takes a patient's blood pressure

SIR – J Meirion Thomas (“Part-time GPs are an insult to taxpayers who trained them”, Comment, September 29) criticises the modern training system, but appears not to appreciate how massively its funding and content have changed.

There needs to be a greater understanding of the realities – and indeed the horrors – facing our young doctors as they try to train weighed down by debt and struggling with a grossly underfunded infrastructure.

Richard Sinnerton FRCS
Sunningdale, Berkshire

SIR – At our local surgery there are only locum doctors, and it is only possible to get a same-day appointment – meaning that, by the time you reach the front of the queue, there are none left.

“Try again tomorrow” is the mantra.

In desperation I paid £110 to a private doctor, who saw me almost immediately. He diagnosed the problem, and later that day I saw a consultant for £240. My medication cost £88. I feel so sorry for those who are sick but cannot afford to do this. And will the NHS repay me?

Greig Bannerman
Frant, East Sussex

SIR – I applaud J Meirion Thomas’s suggestion that medical students, in return for free training, should work full-time in the NHS for a fixed period.

He goes on to cite medical students in the Armed Forces, who must serve a minimum number of years or repay their loan. In fact, this extends beyond medical students. As a former Army officer, I was required to sign a time bar on a number of occasions following completion of various training courses, so that the Army could be sure it was getting a return on its investment. I did so willingly.

Colonel Philip Barry (retd)
Dover, Kent

SIR – The sad fact is that the job of a full-time GP is now largely unmanageable. Even working what is called “part-time” usually means working what would normally be considered full-time, or longer, and includes many hours of paperwork on top of patient appointments. There can be as many as 70 of these per day, which is not safe for patients or GPs.

Despite an encouraging rise in GP training numbers, more GPs are leaving our profession than entering it because of workload pressures. Last month, general practice delivered five million extra appointments for patients than in August 2019 – equating to 150,000 extra appointments per day – all with 883 fewer GPs than in 2019.

GPs deserve to work in an environment where they can provide excellent care to their patients without jeopardising their own health and burning out. That’s why we need a fully funded national retention scheme and measures to reduce the amount of time GPs are spending on bureaucracy when they want to be with their patients. The newly published Long Term Workforce Plan includes proposals for doubling the number of medical students and increasing the number of GP trainees by 50 per cent, but this will take some years to bring to fruition, and we urgently need to work on retaining the GPs we already have.

We should be applauding our hardworking, dedicated GPs and their teams, not criticising them or threatening to punish them for trying to protect their own health and well-being so they can keep their patients safe.

Professor Kamila Hawthorne
Chair, Royal College of GPs
London NW1

Sunak changes gear

SIR – You report (September 29) that Rishi Sunak is to “block new 20mph zones”.

Is he a closet Conservative?

Alan Sabatini
Bournemouth, Dorset

SIR – Rishi Sunak has decided to support long-suffering motorists by restricting the imposition of more 20mph zones.
Call me cynical, but I have seldom seen a more obvious attempt to win votes by a party with its back to the wall and facing a heavy defeat in the next general election.

The Conservatives didn’t win the Uxbridge and South Ruislip by-election in July: it was gifted to them by the Mayor of London, when he pushed Ulez expansion through against the wishes of most Londoners.

To stand any chance of winning, the Prime Minister needs to produce a credible plan for growth and cut taxes. Tinkering with speed limits is simply moving the deckchairs on the Titanic.

Alan Ferguson
Hadleigh, Suffolk

SIR – Tom Harris (Comment, September 28) rightly says that for many years the Liberal Democrats, and before them the Liberals, have been seen by other parties as opportunists, their campaign leaflets in different parts of the country often contradicting one another.

Their inability to achieve consistency and credibility will surprise no one who recalls that, in 2016, following the EU referendum, Tim Farron, the then party leader, refused to accept the vote, despite his distinguished predecessor Paddy Ashdown having declared on the morning of the poll that, whatever the result and however narrow, the will of the people must be respected.

Graham Shipley

Pupils missing school

SIR – It is very disturbing to see the increase in the number of children now missing school (report,, September 27).

Reading the education select committee’s report, it is heartening that some vital evidence was taken from the children themselves.

The two major strands were the worrying loss of enrichment programmes – such as opportunities in the school day for children to exercise, and to achieve in non-academic subjects such as art, music and drama – and the lack of mental health support. Bullying also causes deep unhappiness and must be dealt with effectively and fast. I have personal knowledge of children made very reluctant to attend school because of bullying, and other young people who were blamed for special needs such as dyslexia instead of being supported.

Children want to feel happy, successful and safe. If we listen to what they tell us about schools, we may greatly improve education – not only for those who are missing, but for all our children.

Dame Esther Rantzen
Founder and president, Childline
Lyndhurst, Hampshire

SIR – I note with bemusement the complaints that the Government should have put children’s interests first and not closed schools during the pandemic because pupils were, by and large, not affected by Covid.

There are several reasons why schools had to close, not least because the adults in them had to be protected. Without teachers and the auxiliary staff there could be no schools. Their closure was a necessary evil, and it is wrong to criticise a government trying to make the best decisions based on the science at the time.

Victoria Hawkins
Ludlow, Shropshire

SIR – John Sheridan Smith (Letters, September 27) argues against sport in schools.

I was not very academically minded, but somehow won a scholarship to my local grammar school. While good at English, history, geography etc, I struggled with maths and the sciences, and it was purely the sport on offer that kept me going. 

I played cricket and rugby for the school, captained my house team and was a champion javelin thrower. Without these activities, I am sure I would have become another truancy statistic.

There is also the fact that, if you live in a rural community, there is far less likelihood of organised sport being available without some travelling being involved.

Lee E Brown
Hyde, Cheshire

Conserving Clandon

SIR – Roger White’s letter (September 25) criticising the National Trust’s approach to conserving Clandon Park suggests that the “hard-line” conservation views set out by William Morris in the founding of the Society for the Protection of Ancient Buildings (SPAB) almost 150 years ago are at least in part to blame. SPAB’s Manifesto stands against destructive and speculative restoration and encourages informed and sensitive conservation. Authenticity is key.

The fire was a huge tragedy, and the Trust’s proposals will provide for the meticulous conservation of the surviving parts along with imaginatively integrated modern spaces in the areas that were badly damaged. It will make use of this country’s world-standard conservation, architectural and engineering specialists, working with both old and new fabric, to create an authentically 21st-century response.

The 1877 manifesto was responding to Morris’s belief that the later Victorian period “had no style of its own amidst its wide knowledge of the styles of other centuries”. Today, this country’s approach to thoughtfully integrating new design with old is widely, and rightly, praised internationally and is not seen as being “hard-line”. There can be authenticity in both old and new elements.

Duncan McCallum
Chair, Society for the Protection of Ancient Buildings
London E1

SIR – S J Morris (Letters, September 28) bemoans the fate of Clandon Park House, but it is not yet an approved policy.

The National Trust’s behaviour and plans for the future can be addressed quite simply by members over the next few weeks.

We have all received the AGM voting papers, and for those members unhappy with the Trust’s current direction, their opportunity to make their views known is now. I urge all members to read the resolutions carefully, examine the statements of the candidates for election and vote accordingly.

Taking the soft option of the “quick vote” should be avoided.

Dr Michael A Fopp
Soulbury, Buckinghamshire

Inspiration from artists getting better with age

Mick Jagger during a show at Amsterdam’s Johan Cruyff Arena last year
On a roll: Mick Jagger during a show at Amsterdam’s Johan Cruyff Arena last year - Getty

SIR – With the Rolling Stones releasing a single that is “the best thing they have done in decades” (Arts, September 29), and Michael Caine said to have produced a career-high performance in the forthcoming The Great Escaper, I am beginning to wonder whether, at the age of 60, I have my best days ahead of me.

Bill Hicks
Whitstable, Kent

Tines and prongs

SIR – I must take issue with Timothy Bidwell’s assertion (Letters, September 28) that a table fork has tines rather than prongs.

A tine is a piece of sprung steel used on harrows and some types of garden and agricultural fork. A prong is a piece of rigid steel as found on table forks and garden digging forks.

While the dictionaries maintain that the words are synonymous, the dictionaries were not written by the sons of the soil.

Tom Archer
Saffron Walden, Essex

SIR – When I was growing up in 1930s Stoke-on-Trent, in the home of my maternal grandparents a prong was a wooden-handled fork with two tines.

Ken Legan

Household helpers

SIR – Alexandra Elletson (Letters, September 27) has named her robot mower Martha.

There is a long tradition of naming appliances in the Stitz household too. Our mower is called Patrick after the actor, our sewing machine is Pearl (it’s a Singer), and although we changed brands many years ago our vacuum cleaner is still referred to as the J Edgar.

Norma Stitz

SIR – Alexandra Elletson appears to be a kinder employer than we are. Our robot mower, Roger, works from 8am until 10.30pm. He is soon to be joined by a smaller version of himself, Rogerson.

Karen Nissen
Winson, Gloucestershire

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