I am delighted that Dr Peter Smith is able to rearrange his staff's work commitments with such apparent ease that he can undertake extra work in the evenings and weekends with great economy (GP, 19 October).
But I would ask why he feels that it is necessary for him to do so without any consideration of GP time and its costs.
Does he propose simply to work longer hours for nothing (which is what the idiots at the DoH are really hoping he'll do), or is he in fact planning to have a morning or two off somewhere in the week to compensate - which will ruin the access figures in a small practice?
Does he assume that any salaried doctor will likewise be delighted to work evenings and weekends, given that at least some of them chose salaried posts to fit family commitments, and moreover that they will do so for no extra pay?
Who does he think will staff out-of-hours if the local GPs are all doing late surgeries?
It's this sort of posturing that persuades our political paymasters we can be blackmailed into ever more effort for ever-decreasing reward.
The money is not extra cash; reducing the quality points available is effectively a pay cut, so, even if the cost of extended hours is exactly the same as the 'new' 60 points, it's still a pay cut because we would not have had to spend that money on more receptionists' salaries.
Dr Richard Hook, Marlborough, Wiltshire.
