British general practice has always been the jewel in the NHS crown, and the envy of the world.

It is now under grave threat - polyclinics, Darzi centres and becoming employees of Tesco, Boots or Virgin are just a few of the nightmares on the horizon.

The essence of general practice, and what is most valued by patients (and doctors), is the doctor-patient relationship, a relationship that is built up over the years. It is not just a quick consultation at 7am on the way to work as a City whizz kid.

General practice is more about a lifetime of care from someone the patient knows and trusts. This is particularly important for those with chronic diseases or patients who are ill and dying. A familiar face is everything.

Cutting costs at all costs
The government's main incentive is to reduce costs. Nurses are less expensive than doctors, and thus we see them taking a larger role in the projected polyclinics, as they have already done in out-of-hours care.

What is essential is that our patients receive the best quality care, and in many cases that must be provided by a doctor.

In the press recently, much has been said about the number of women entering general practice. The government sees polyclinics as the way forward because it thinks (mistakenly) that women will not mind being salaried, and will tolerate being controlled by large private companies. Nothing could be further from the truth.

Practice commitment
Women doctors, just like men, want the commitment of a practice partnership. It is essential that incentives are introduced, so that practices take on partners, rather than salaried doctors or nurses. A nurse is a valuable member of the primary care team, but she is not a doctor.

Women, and men, also want families. We all know that it is best for children in the early years to be looked after by their mother or father. In Scandinavia, men and women are able to share 'maternity leave' and this might be popular with some families in the UK.

At present, practices are reluctant to take on women of child-bearing age because of the hassle that ensues if she becomes pregnant. It is essential that a practice is not penalised when a woman is on maternity leave. As a top priority, more satisfactory structures must be put in place so that this does not occur.

I have been a GP for more than 20 years. I love the job and do not want to see it destroyed by government machinations, as is happening now. What is not important is whether your doctor is a man or a woman.

What our patients want is a doctor who cares about them, who knows them and who has some control over how the care is given. We must do all we can to preserve this.

Dr Fabre is president-elect of the Medical Women's Federation (www.medicalwomensfederation.org.uk )

Support the campaign
The Medical Women's Federation is the first of a number of groups to explain why they are backing GP's Valuing General Practice campaign.

If you would like to support the campaign, write to us at GPValue@haymarket.com or go to www.healthcarerepublic.com/value to find information and tools to help you get involved.

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