Letters: Doctors under pressure are well aware that general practice is broken

SIR – GPs have not been “missing in action”, as J Meirion Thomas claims (Comment, May 15). Rather, they switched to a mandatory total triage model in March 2020 to protect patients from catching Ccovid in the waiting room.

GPs have continued to see patients when necessary, but many issues do not require a face-to-face consultation. Taking a good history and knowing your patients help to provide continuity of care. We already have teams of allied professionals working to do this, either remotely or in person, and the polyclinics you advocate would move further away from these relationships.

We can agree that general practice is broken. This is due to chronic underfunding of a service that provides 90 per cent of NHS contacts for about 9 per cent of the budget. The current system allows most patients to access their GP within one or two days, compared to waiting weeks pre-pandemic.

GPs are human; we are trying our best with limited resources, while dealing with more patients than ever before, as well as delivering 75 per cent of Covid vaccinations. Why not come and spend a day in general practice to see the demands for yourself.

Dr Rosie Shire
GP, Doctors’ Association UK

SIR – One factor that led to many of my generation of GPs retiring (report, May 13) was the sheer weight of bureaucracy emanating from the government and professional bodies, which we completed in the knowledge that most of it would not be read.

The second factor was the inexorable rise of the litigation culture, which meant that every appointment, however trivial, had to be meticulously documented. This signalled the end of the five-minute consultation, which was the only way we could deal with the volume of patients presenting.

Finally, free healthcare has created a sizeable minority of patients whose use of the NHS is out of all proportion to their need, resulting in reduced access for the majority, and an individual GP workload that is unsustainable.

Dr Chris Nancollas
Yorkley, Gloucestershire

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SIR – Like Bill Easson (Letters, May 12), I was taught that a proper consultation began with a history, moved to an examination, included a discussion with the patient, and came to a diagnosis, with a suggestion as to treatment last.

It is with regret that I see more and more difficulty in making a face-to-face GP appointment and I fear the consequences should this trend towards electronic medicine continue. There may well also be a marked increase in legal fees.

Dr Malcolm Freeth
Bournemouth, Dorset

SIR – To visit my GP I have to ring the surgery at 8am and join a queue of at least 30 people. An hour later one tends to give up. Is this acceptable?

Geoff Dickman
Maldon, Essex

A bright future

SIR – I must disagree with your feature on Farrow & Ball (May 13). Hempel, that has bought it, has manufactured paint in the UK for more than 60 years and also owns Crown Paints. Better them than an investment company that would strip Farrow & Ball of its assets.

Tony Gadd
Southport, Lancashire

Baroness O’Cathain

SIR – Apart from her five years at the Barbican, Baroness O’Cathain (Obituaries, April 28) spent five decades as a pioneering business woman and as a highly effective member of the House of Lords.

Detta O’Cathain blazed a trail in business in the 1980s, being among the first female non-executive directors to serve in FTSE 100 boardrooms, including those of Tesco and British Airways. Her sharp mind and ability to get to the heart of complex problems won her respect, if not friends, in a male dominated world.

As Baroness O’Cathain she used her platform to inspire young women to enter business, and acted as a personal and professional mentor to many.

As chairman of the influential European Union subcommittee dealing with the workings of the internal market and infrastructure her reputation for assiduous preparation and forensic questioning of witnesses was legendary.

In a political world often characterised by the concealing of true feelings, with Detta you always knew exactly where you stood – whether you liked it or not. It was not personal. Her interest was in getting to the truth, solving a problem, not in defending a party line. This approach won her many friends on all sides of the House.

Detta was a good friend, good company, quick-witted and blessed with a self-deprecating sense of humour. She will be well remembered.

Lord Fowler
Baroness Smith of Basildon
Baroness Goldie
Lord Faulkner of Worcester
Lord Lucas
Baroness Fookes
Lord Bates
Lord Hayward
London SW1

Fishy business

SIR – Never mind garlic (Letters, May 13). Is it not even crazier that so much of the fish we buy here is either farmed in Vietnam or packaged in China?

Anthony Whitehead
Bristol

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Oxford’s historic abuses

SIR – It is disappointing that students who theoretically have the intelligence to gain a place at Oxford do not understand that they are benefiting from an institution riddled with historic abuses (report, May 15).

The entire university was initially constructed on tithes and serfdom, and the amassing of land and wealth to which it was not entitled. If students prefer metrication over “imperial measures” they are condoning the brutality of the Roman conquest and its more recent championing by Napoleon Bonaparte.

One cannot cherry-pick aspects of our historical culture, otherwise we have to abandon the English language in this absurd cultural cleansing.

Dorian Wood
Castle Cary, Somerset

Memories of Beale’s

SIR – Christopher Howse’s feature (May 14) on the closure of Arthur Beale on Shaftesbury Avenue, brought back memories of the 1970s, when I worked around the corner in studios in Neal Street and was involved in the design of Terence Conran’s Habitat shops.

Arthur Beale supplied several pieces of equipment, most notably the stainless steel “straining wire”, and the fittings for pulling it taut, that we used as intermediate rails in staircase balustrades.

How sad that a business with such an incredible history is about to disappear.

David Salter
Richmond, Surrey

SIR – I was an articled clerk to the firm responsible for Arthur Beale’s annual audit. This was considered to be a plum assignment, very different to the usual factories and offices we visited. We would do our checking, surrounded by ropes, flags, buoys and other sailing equipment.

William Fitzhugh
Reading, Berkshire

SIR – Beale’s was of use to gardeners beyond the incidental provision of brown paper bags for seeds.

Twenty years ago I needed hemp rope to support the rambler roses I was planting at our house in France. The 30 metres I bought from Arthur Beale are still supporting a wonderful display of roses every year. I might even get to see them this summer.

Peter J Howard
Spreyton, Devon

Paying for care

SIR – In cautioning against “millions of struggling young people (being) required to bail out the asset-rich elderly” for their care, Philip Duly (Letters, May 14) challenges the Dilnot report’s proposals. However, unfair though those may seem to the young, because the elderly (and infirm) did not have to subsidise elderly care when they were young, the proposals represent a necessary stopgap measure to meet the current situation.

Today’s young will also benefit from having their own care in old age duly serviced by the recommendations, which will be adjusted over time to achieve a more equitable solution. We all grow old eventually.

Bruce Denness
Niton, Isle of Wight

Horse sense

SIR – We had a pony who, once let out of his stable, would potter around on his own (Letters, May 15). When he was ready to go back to his paddock, he would knock at the kitchen door.

Letitia Hayward
Loddington, Northamptonshire

Britain’s railways have been run down for decades

SIR – The need temporarily to withdraw trains when potentially dangerous is nothing new (report, May 14).

It happened on two occasions in the 1950s, both involving the withdrawal for safety checks of a whole fleet of steam locomotives: the Great Western “King” class in 1956 and the Southern “Merchant Navy” class in 1953. Their absence was covered by sending spare locomotives from other parts of the country.

Since then our railways have had all spare capacity in track, rolling stock and locomotives stripped from them, robbing them of the ability to respond flexibly to such problems.

The Government can require the railways to provide cover all it wants, but the fact that it’s not there is due to successive governments and the Civil Service destroying what was once the finest railway system on the planet.

David Pearson
Haworth, West Yorkshire

The Sussexes should renounce their royal titles

SIR – The Queen wears two hats, she is both head of state and the senior member of the Royal family. When Prince Harry joined the Army he took an oath to serve not his grandmother, but the head of state. When he married Meghan, the Queen gave them the titles of Duke and Duchess of Sussex so they could carry out official duties.

Harry has failed to grasp that while his family problems are private, his official duties are open to public scrutiny. As he has made it clear that he does not want to serve the Queen as head of state, it is inappropriate for the couple to keep their titles.

Peter Amey
Hoveton, Norfolk

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SIR – Like Sheri Jacobson (Analysis, May 14), as a retired therapist I know that therapy offers us the chance to understand ourselves and be healed in a way that helps us to move forward. It has nothing to do with pulling down and stamping on others, which is not conducive to human well-being. However, as part of the me-first, emote-it-all generation, Prince Harry is using his new awareness to persecute the Royal family before a global audience.

He is hurting his new family as surely as his own was damaged by divorce and death. His lack of psychological awareness is astonishing.

Eleanor Patrick
Elsdon, Northumberland

SIR – The Duke and Duchess’s website claims that they are “serving the Monarchy, honouring the reign of Her Majesty Queen Elizabeth II” and that they “deeply believe in the role of The Monarchy and their commitment to Her Majesty … Their roles will continue to reflect their sense of duty and allegiance to the Monarch.” How so?

Elisa Stanton
Alton, Hampshire

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