NHS humbug
ir: While 1 would agree with much of John owan Wilson's account of the first twenty rs of the NI-IS, I really must take issue with over, his view that the future of general ractice should be based on Health Centres and olyclinics and the loss of the personal doctor 2 July). The GP has always existed, not as a ntimental idea, but as a hard practical neces- ty as an agent for dispensing cheap medical re for the mass of the population and cream-
g off the cases that require expensive specialist gnosis and treatment.
When the is started, the community service s starved of money in order to keep the pital service going, and the erroneous idea ew up that the GP'S work was best done in the spital out-patient department by specialists. In actual fact, the advances in medicine have en as great, if not greater, in the treatment common diseases—hypertensive, heart, chest, n, mental and emotional illnesses—as in the re spectacular hospital ones, but, and this is Point that the specialists-find it impossible to sp, these illnesses and the amazing new mamentarium of drugs for treating them can managed quite easily in an ordinary surgery the modern GP providing he is given adequate tha rsing and secretarial help. In other words, the effectiveness of the GP
depends not so much on modern buildings and expensive equipment, but on his clinical skill, his knowledge of drugs and his personal know- ledge of the patients, which latter is not an out- of-date sentimental idea but a modern, cost- effective principle.
That the GP Health Centre Polyclinic idea is official policy 1 will readily admit, the specialist- dominated medical establishment and the Civil Service, in their ignorance, will see to that, but the real reason for this policy is political not medical. A group practice polyclinic, with an appointment system and a waiting list, is a ready way of rationing scarce medical care, as a patient who was cited in 'Spectator's Note- book' of the same issue found out.
This rationing and the resultant 'crisis medicine' is a far cry from a comprehensive service, and bears hardly on the elderly and chronic sick and on those who are not aggres- sive enough in claiming their rights.
We are getting towards a 'free for all' service but not in the sense that the founders of the NHS envisaged.
C. G. Elliott Rosemount, East Hoathly, nr Lewes, Sussex
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