Doctors knew their patients

I WAS disturbed to read one of the latest proposals put forward by Lord Darzi, that "popular GPs" - those with a large number of patients registered with them - should be paid more than others.

This was an idea favoured by Margaret Thatcher which shows an utter failure to understand the nature of general practice and, as a family doctor who was in a long-established three-doctor practice during the golden years of the Crossman contract, I should advise anyone thinking of registering with such a Darzi-approved doctor to do no such thing.

During those "golden years," the three of us could have had 10,500 patients registered with us. But we felt that 2,000 per doctor was a number more appropriate to good medical practice in that there was time to listen properly, get to know patients and treat them as individuals rather than "cases."

Ours was an old practice, first established in the 19th century, and its "core" consisted of 15 to 20 extended families, so that what was happening in one household could affect many others, an important factor which will be lost if huge polyclinics replace current group practices.

When we said that we knew all our patients, we were told: "You may think you know them, but you only know the ones that attend regularly." But there was one occasion when we were able to prove that we certainly knew 95 per cent of them.

MADELEINE SHARP
Coventry