Bad prescription

The need for a reappraisal is reinforced by the perturbing report, published today by the King’s Fund, which reveals discrepancies in the performance of individual GP surgeries.

This is borne out by the wide variations in referral rates and diagnosis for cancer patients. In too many instances, family doctors are far from punctilious when sending a patient to a hospital specialist – presumably because they are distracted by the wide-ranging nature of their responsibilities.

Mr Lansley needs to establish why this is so. Every family should be able to command confidence in the competence of the local health centre. It should not be a postcode lottery.

It is also important that Mr Lansley takes note of growing concerns about continuity of care, with only one in four patients able to see their preferred doctor.

This is particularly crucial for senior citizens or those patients with long-running illnesses. They find it easier to gain the confidence, and respect, of their GP if they see the same practitioner wherever possible rather than having to explain their medical history to different individuals.

Yet it is difficult to see how this trend will be changed if family doctors are preoccupied with commissioning services, and balancing budgets, rather than concentrating on their vocation – the treatment of patients.

GPs are doctors, not accountants, and Mr Lansley needs to recognise this before he undertakes reforms that he later regrets.