Sir, “Martini” healthcare — any place, anywhere, any doctor — as espoused by David Aaronovitch (“Ignore GPs. Polyclinics are the answer”, Feb 19) is all very well for those people who enjoy good health and rarely have to consult their GP.

But his dismissal of GPs as providers of prescriptions and “inexpert” conduits to specialists is insulting to the family doctors who are working hard daily to improve patients’ lives — and to the thousands of patients who rely on their local practice.

The Royal College of GPs is not opposed to the concept of polyclinics per se. They will be a workable option in certain parts of the country, especially for “commuter” patients who are otherwise able-bodied and healthy. But we do have concerns about continuity and quality of care and are doing our utmost to make sure that the GP-patient relationship does not become a sacrificial lamb.

Before Lord Darzi’s review was announced, the RCGP launched its own blueprint for the future of the NHS. Under our proposals, general practices would join forces in “federations” to deliver a wider range of services — including X-rays, scans and mental health services — in the local community, meaning that patients would be sent to hospital only when absolutely necessary and GPs and specialists would work more closely to deliver seamless care and aftercare.

We are also concerned that scant attention is being paid to the cost of running the services promised. This week we released our latest figures showing that GP care for a whole year costs less than a single day’s hospital admission.

General practice is already the most effective — and cost-effective — part of the NHS. It is the solution to an improved thriving NHS, not the problem. Patients expect cradle-to-grave care provided by general practice and why shouldn’t they receive it?

Professor Steve Field
Chairman, Royal College of General Practitioners

Sir, Generalists have an important role to play in all health systems, as of course do specialists. You need look no further than the US to see the cost and failings of a specialist-driven health system.

To gain the knowledge required to manage chronic disease and spot the early signs of serious illness GPs train for a minimum of ten years, gaining at least two degrees at medical school followed by long hours in hospital as junior doctors before sitting postgraduate exams.

I am sure both Mr Aaronovitch and his family are blessed by good health and for them the occasional visit to a polyclinic will do just fine, but for the millions of patients in the UK suffering with chronic disease continuity of care is vital.

If it comes to a straight choice between a private GP you know or an NHS one you don’t, I know which I would choose.

Robert J. White
London W11

Sir, I don’t think most UK GPs would be too upset if we ended up with Scandinavian-style polyclinics, but the recent past would suggest that we are more likely to end up with a cross between the out-of-hours care fiasco and the patchy level of NHS dental provision. Private companies will only want to operate in “profitable” areas. The government drive for cost savings would mean the polyclinics being run by private companies employing overseas-trained doctors on short-term contracts. When complex medical problems are encountered then the quickest, cheapest way to deal with them will be to pass the buck to the hospital sector. The cost savings would be rapidly swallowed by increased admission costs to A&E.

Dr Alan Stone
Cardiff

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