Letter: One reason that the British NHS has been such good value for money for many years is the single point of entry to healthcare.

This meant that unless it is an emergency or we are away from home, our first port of call is our own general practice.

That practice can point us to the most appropriate service for our need and the practice maintains a full record of all the treatment that we receive regardless of where we receive it.

This single point of entry saves the patient time and makes for efficient use of health services.

For many years the French had an open access system whereby patients could go to any doctor they want at any time. The result was that patients would often consult an inappropriate specialist for their condition, have some tests, and be no further forward.

They would have to start again with another doctor. This system practically bankrupted the French health service and they have now introduced a system much more like the British one where the GP makes the referral to the most appropriate specialist.

Since the launch of NHS Direct in 1997 we have seen a whole host of new ways for patients to access healthcare. Dr Paul Spencer lists them in his letter of January 2.

Alan Stewart in his letter of January 9 makes the point that one needs to consider not just cost but also value. Shropshire’s Health Overview and Scrutiny Committee had a responsibility to consider both value for money and quality of care.

When it was faced with the proposal to introduce the new Darzi clinic (or polyclinic) in Shrewsbury members of all parties united in the view that this was not a good way to improve the healthcare for the people of Shropshire.

This service is rumoured to have cost around £10 million.

That money could have made very significant improvements to practices all round the county.

Dr Charles West
Shrewsbury