GPs should stay GPs

Sir, Nigel Hawkes reveals criticism of the ability of some generalpractitioners to carry out their responsibilities competently whenremoving skin lesions that may turn out to be malignant, withdisastrous consequences (report, July 14).

Is it not time that we give up the comforting mantra that anyone,with a little extra training, can do as well as anyone else?

During my time as a GP I spent quite a lot of time teaching doctorsto be better general practitioners: my aim was to help them tobecome first-class GPs and not second-class specialists. While itmay be tempting for governments to encourage professional ego, andsave money in doing so, surely we must now face up to the factthat, as in business, there is a “professional Peterprinciple” that has to be recognised. Each of us can onlyreach the level of our own incompetence and to attempt otherwise isthe road to a second-class service, if not to disaster.

General practice is a speciality in its own right: prying intoother specialities should not be encouraged. In this age ofhyper-specialisation, there is no room for GPs to carry outspecialist activities without full training. Equally, professionsancillary to general practice, such as nursing and pharmacy, shouldnot take on the role of general practice. One does not expect adietictian to necessarily be a good chef (and vice versa) and thesame principle should apply to the various disciplines withinmedical care.

Dr James Carne

London N6