Sir, - The new health strategy document outlined in Dr Muris Houston's fine article in your edition of July 28th is a frightening prospect and will dismantle the primary care service so patiently nurtured for the past three decades.
As a family doctor for the past 25 years, with a teaching role in the past 15, I have realised that:
1. Sixteen million face-to-face consultations occur each year in general practice (ICGP Workload Study 1998);
2. On average, two to four problems present at each consultation.
In my work on the Human Doctor Programme at the University of Limerick, research has shown that often neither the patient nor the doctor is aware of the nature of the problem at the beginning of the consultation.
With this proposed new 1850, dial-a-team-member-to-solve-your-problem strategy, the sensitivity of referrals to costly, highly-paid team members will rest with the patient.
Patients with poor insight will struggle and the system will be dictated by what patients want. This may sound like a good thing, but experience has taught me that patients do sometimes need gentle persuasion to do what is best for their health. - Yours, etc.,
Dr M. Griffin, John's Square, Limerick.