Sir, That Alan Johnson, the Secretary of State for Health, should continue the Government’s apparent vendetta against small GP practices is both curious and worrying.

Mr Johnson seems determined to target single GP practices even though there is hard evidence of small practices’ superiority in providing patients with access to primary care medical services and superiority in patient satisfaction. It is worrying in the extreme that the Department of Health is choosing to ignore the importance of existing, well-established and much loved local practices.

The proposed injection of capital into general practice is surely to be welcomed, but the mechanism by which this is happening is a problem. It threatens the stability of all practices and smaller ones in particular. A well-intentioned scheme can look fine from the strategic level looking down but be quite different from the bottom looking up.

One of the Government’s 50 new GP practices will open its doors a few hundred yards from my door and will attempt to create a list of 6,000 patients by luring them away from existing practices. One of the expressions of interest for the Darzi practice is known to come from a consortium led by Sainsbury’s. My practice, like all others in the town in which I practice, is targeted to lose 20 per cent of our patients; this would cause a 12 per cent to 15 per cent loss of practice income, which in turn will necessitate some reduction in services.

Currently, my practice delivers 98 per cent quality medicine as judged by the Department of Health’s Quality and Outcomes Framework, a 99 per cent patient satisfaction as judged by the Department of Health’s recent patient access survey and “Excellence in Public Service” for the past 11 years as judged by the Cabinet Office’s Charter Mark. It will prove difficult to maintain such quality and the enthusiasm to sustain it, when contesting the predation of new practice on our door step.

Michael Taylor
Chairman, Family Doctor Association, Heywood, Lancs

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