Letters: Reading between the lines of PM's statement

Gordon Brown's letter (GP, 31 October) says a lot but there is a lot between the lines, so re-read it as follows:

Effective primary care is at the heart of our ambition for a 21st century NHS (this is a comment to sweeten the GPs, but the GPs don't realise that to get the effective care I need to get rid of the inefficent GPs - those over 50 on the golf course), which is as good as keeping people healthy as it is at treating the sick (I will get the GPs to screen more but for no more money).

We have ambitious plans to expand the number of GPs (more doctors - not as well trained but because there will be fewer jobs they will work for less), enhance the range of services offered in primary care (get the lazy GPs to do more for even less), improve access for patients (extend the extended hours) and support improvements in primary care (as long as it doesn't cost any more money).

Giving professionals a greater say over their own services and the future of our NHS has been a major priority over the last year (practice-based commissioning I presume - if your PCTs let you change anything).

That is why Lord Darzi (I remember him - yes, a surgeon - he must be better than GPs so he knows best) was asked to conduct his review through extensive consultation, why we are now seeking to give clinicians much greater involvement in decision making (so when it goes wrong, there is someone else to blame) and why in primary care in particular we are expanding the opportunities for professionals to run and manage their own services (but we won't pay for it).

I welcome all opportunities (as long as they are cost neutral or get lazy GPs working more) such as the GP35 initiative (what will they know), to give staff a greater voice in the NHS (but I won't hear them as my hearing aid is switched off).

Dr Robert Mitchell, Poulton-le-Fylde, Lancashire.

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