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Poor practise

Daniel Angelini’s piece on the ongoing situation with Integral Medical Holdings ‘call system’ highlights the odd relationship between the local Clinical Commissioning Group and the individual surgeries at the heart of the problem (SA 15 Nov).

The CCG “acknowledges the frustration being felt by patients” and claim it is their “absolute priority to investigate and resolve these issues as quickly as possible” – except of course that simply is not the case at all.

The CCG is largely made up of doctors, some of whom used to own a practice which they then sold to IMH and in all probability are now employed by IMH.

The reality is that the CCG cannot compel IMH to take any action to resolve the ongoing situation; they can investigate why there is a problem, although anyone with a modicum of common sense will be able to provide the answer, just as the same person will be able to identify a solution.

But the problem lies in the simple fact that after paying the doctors significant sums to ‘buy out’ their practice (the word practice being a euphemism for private business), and then employing those same doctors on substantial salaries, Integral Medical Holdings need to make a profit.

To do that, they have adopted the text book approach of reducing what they term non-essential staff and consolidating various activities into manageable silos.

Of course this may result in some short term issues of adjustment, but I suspect the real issue was pretty poor planning in the first place.

Des Morgan, Caraway Drive, Swindon

Time to get tough

In your report (SA 14th Nov) “The spitting came out of the blue…”, you report the appalling figures of attacks on paramedics and others. There have been other reports of attacks on doctors and nurses in hospital – particularly in the A&E department.

Whenever such reports are published ‘the management’ always says that they “will not tolerate such abuse”, and that “we have a zero-tolerance policy” for such behaviour; even that they will prosecute offenders. Yet how often do we hear of such prosecutions?

Maybe if there were more cases coming before the criminal courts (for, in such circumstances, the offenders are easily identified), and ‘exemplary, deterrent’ sentences were handed down, with appropriate publicity, this might encourage at least some offenders to be less aggressive.

Malcolm Morrison, Retired trauma and orthopaedic surgeon, Prospect Hill, Swindon

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