ANDREW Martin (Feb 7) pursues his proposal to train nurses to replace doctors, ignoring the already serious shortage of nurses.

I have granted that some duties previously the preserve of doctors are now discharged by nurses, and no doubt, if there were enough nurses, there could be some extension of that.

However, a doctor’s medical education and professional training are not only a great deal longer than a nurse’s, but are substantially at a technically and conceptually different level.

Extra training is therefore not a simple matter, and to ask nurses to undertake responsibilities for which they are not properly equipped would be medically, legally, and morally absolutely indefensible.

Mr Martin is apparently content that doctors whose skills have been overtaken by rapid developments in medical knowledge and techniques should be allowed to practise on an ad hoc basis without any check on their updating.

I think this is irresponsible. If he thinks the revalidation process is more cumbersome than it needs to be, which might be arguable, it would be helpful if he were to give some clear and precise details of what should change, avoiding vague generalisations and GMC conspiracy theories.

The last Labour Government’s contract with GPs, intended to make General Practice more attractive, has indeed been criticised as well as defended.

However, doctors are retiring in many cases because they have reached retirement age without adequate replacements having been trained; those retiring earlier than they otherwise might often cite overwork and stress resulting in loss of job satisfaction, an often overlooked motivation in public service professionals, and it is those factors that seem to make General Practice unattractive to newly-qualifying doctors.

The greater the shortage, the more stressful and less attractive that role will become.

The problems are a great deal more complex than Andrew Marin’s account allows. We might soon be at the point of no return, and the Government seems largely indifferent.

BARRY TEMPEST

Dorchester

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