Loss of doctors. Poor retention …. The fun and variety in a job is important… Home visits need to be fostered and not rejected in an ageist society.

Whilst the different political parties use their energies on health bribes to get our votes (Matthew Paris in the Times 16th November) , it might do well to reflect on why we have too few staff, and why we have 1/6th of the number of scanners and investigatory plant of similar G8 nations.

The letters in the Times a re listed in reverse order, and in many ways the last one sent by Professor Goddard says it all. The call to reject home visits will lead to elderly people getting inferior diagnostic assessments for staff who are not trained in differential diagnosis. The only reliable answer will be for these elderly people to have private doctor visits where these can be bought. In poor and rural areas the private option will not be there, and a health divide will ensue. We would be creating an ageist spartan society in the modern world.

Sir, Dr Carole Luck (letters, Nov 15) may not know that four-day, 38-hour working weeks are the norm for junior doctors in Australian emergency departments. Their education isn’t damaged by this. Indeed they have sufficient energy to concentrate on their studies and their patients. This is one reason why so many British junior doctors leave the NHS for Australia. I should know. I was one of them.
Dr Jo Deverill

Sunshine Coast, Queensland

Sir, John McDonnell believes that NHS staff should be included in plans for a four-day working week (“Labour split over 4-day week for NHS staff”, Nov 14). The NHS has been brought to its knees by the introduction of the European working time directive allowing junior doctors to work no more than 56 hours per week. Junior doctors learn through experience but long hours and weekend shifts fill much of that time, so they do not have the benefit of all the teaching available during the week. A four-day week would seriously damage the education of young doctors and possibly sink the health service.
Dr Carole Luck
Retired consultant radiologist, Windsor

Sir, A four-day, 32-hour week for NHS workers is an admirable aim but with punitive pension charges putting consultants off overtime, a shortage of GPs and clinicians working significantly longer hours than contracts and acceptable norms, the service is in peril. The priority should be a safe service run by clinicians with sustainable working patterns.
Dr Michael Rooney


Sir, Neither giving more funding to the NHS or outsourcing parts of it will make it better (“Labour will tax rich to give NHS billions more than Tories”, Nov 13). The NHS is a bloated public sector organisation with good intentions that costs the state more than £125 billion a year to run. It needs reform and buying time with more money will not change the direction of travel. How refreshing it would be if the NHS’s imperfections were admitted and careful apolitical steering towards an efficient and effective service could get under way. The NHS needs intelligent support, not political slogans.
Mark Scibor-Rylski

London SW6

Sir, May I make a robust defence of the GP home visit in response to the article “GPs want to remove ‘old fashioned’ home visits from their NHS contract” (news, Nov 12). The information gained from one home visit in terms of a social and psychological assessment of family dynamics is vital knowledge in managing the patient’s condition and is an efficient use of time and effort. Ten minutes spent in a patient’s home tells us so much that is impossible to glean in clinical consultations. It is also vital in managing many elderly patients at home, those with palliative care needs and in offering support to grieving relatives. It must remain an important part of the commitment a GP offers patients.
Dr Richard Morey

Postling, Kent

Sir, I am dismayed that some GPs are considering passing on home visits to other NHS workers (“GPs want to remove home visits from their NHS contract”, Nov 12, & letters, Nov 13 & 14). This is a huge disservice to the public. Our local walk-in centre, which offered an out-of-hours GP service, has become entirely nurse led, which limits what it can offer. I worked as a nurse for many years and learnt many new skills and diagnostic procedures such as prescribing medication, but even with extra training, nursing staff and paramedics will never have anywhere near the accumulated skills of a doctor.
Lesley A Malton


Sir, It may sound promising to hear Jonathan Ashworth pledging £1 billion more per year to train GPs under a Labour government (“Invest to stop people becoming ill in first place”, Nov 13), while the Conservative Party has also pledged to increase GP appointments (“Tories vow to cut waits with 50m more GP appointments”, Nov 9), but in reality, neither of these commitments will deliver more doctors for the NHS. It’s all very well to increase GP training places, but in exchange, which specialties will we train fewer of — physicians, psychiatrists or emergency medicine doctors? All of them have their own shortages.

We need a commitment from the next government to double the number of medical students so that when it comes to increasing the number of GPs, nurses and other medical professionals, there exists a sufficient workforce to do so.
Professor Andrew Goddard

President, Royal College of Physicians
London NW1

The Nuffield trust 3rd July 2015: Focus on: International comparisons of healthcare quality –  An analysis of 27 care quality indicators across 15 countries to explore what comparisons of international healthcare data can tell us about quality of care in the UK.

Beware the grizzled Marxists bearing gifts – The Sunday Times

The Tories and Labour are both trying to hoodwink the public on borrowing Tony Blair

This entry was posted in A Personal View, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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