Favouring a mythological traditional orthodoxy is absurd

BMJ 1996;312:1422 (1 June)

Letters

Favouring a mythological traditional orthodoxy is absurd

EDITOR,--As chairman of Warwickshire general practice commissioninggroup, a course organiser for a vocational training scheme,and a fundholding general practitioner, I wish to respond toPer Fugelli and Iona Heath's editorial on the nature of generalpractice.¹

General practice is evolving rapidly; nearly half of all Britishpractices are fundholding, and over a quarter are part of commissioningstructures. Consequently, many general practitioners have gainednew skills to improve the care of their patients and their populations.For many these are acceptable and pragmatic methods of advocacy.To suggest that all of these skills should be abandoned in favourof some largely mythological traditional orthodoxy is absurd.

General practice must deliver care to all patients. Every consultationand every episode of care must be part of an overall structureof accountability. They cannot simply be islands unto themselves.

General practitioner The Surgery, Barr Lane, Brinklow, WarwickshireCV23 0LN

J Hopkins