I have long argued for better access for migrants to healthcare in the UK; indeed I spoke on this topic at last year's Conference of LMCs. However, I do not agree with some of the points made in the article and am deeply saddened by its tone.

While all persons are eligible to be registered with a GP practice, irrespective of immigration status, not everybody is entitled to be registered. Only persons eligible for free NHS care are entitled to be registered with a GP. For persons not entitled to be registered, such as undocumented migrants, GPs have discretion to accept those patients onto their NHS lists but are not under any duty to do so. We may wish that GPs exercise their discretion in a certain manner but provided they do so in a manner that is consistent and non-discriminatory then they are entitled to exercise their discretion either to register or not register these patients. I am not aware of any statute or court judgment which would preclude GPs from freely exercising their discretion and I note that the author has not provided any references supporting his contention that this would constitute unlawful discrimination.

The author quotes unreferenced statistics from Project London. No further data are provided as to the reason for their clients trying and failing to register with a GP. Fully valid reasons might include that the patient did not live within the practice area, that the practice's list was closed or open-but-full, or that the practice was exercising its discretion not to register persons who are not entitled to free NHS care.

Unnamed other agencies are reported as having used mystery shoppers which are claimed to have produced different results depending on whether an English accent or surname is used. I have read a paper which was presented to City and East London Local Medical Committee several years ago which purported to prove that GP practices in East London were behaving in a discriminatory manner. Supposed proof of this was that they were treating first registrations in the UK differently to patients previously registered with another UK General Practice. It was pointed out to the authors of the paper that it was reasonable and correct to treat these two groups differently as patients previously registered in the UK would have an NHS number and an existing medical record which the practice could access electronically whereas first arrivals must provide additional information so that an NHS number can be generated for that patient.

It saddens me that the BMJ has seen fit to publish unsubstantiated attacks on general practice based on statements from unnamed "other agencies".

To call for well publicised court cases against general practitioners is something I would expect to read in the tabloid press, not in the British Medical Journal.

Bullying gets us nowhere. Threats will get us nowhere. It's time those who say they wish to see progressive change in this area to stop interpreting the regulations as they would wish them to be but rather to work constructively and collaboratively for the change they wish to achieve.

Competing interests: I am an economic migrant, the son and grandson of economic migrants