Someone must be accountable for the obviously preventable death of this woman. A woman who even the day before her death was considered to be intelligently and articulately giving the symptoms of her condition to the doctors (having given 8 doctors her symptoms in 4 daysl!).

What about those who are less intelligent, less articulate. Does that mean that they will get deader quicker ?

If we are to continue to have an NHS, it really needs to be functioning properly and equal to the service it should provide- and that is treating illness to recovery and saving lives.

Given this preventable death of a young mother, the NHS is clearly breaking down, unable to function at even a basic level. Better that people check their own symptoms on the web and if in doubt, go to their local A & E, thereby cutting out the company (or rather middleman) who continues to make huge financial profits whilst people die, and whilst pointing the finger at those who work for them

T. Bishop, London, UK

From 1997 primary care has been de-professionalised and over politiicised. Untested expensive dumbed down "eye catching initiatives" have been introduced to collect headlines but not deliver health care. . Supermarkets.?.shoppers have an idea of what they want when in Tescos; mistakes are not lethal.Human biology is more complex.GB has just spouted a load of jingoistic ignorant drivel...what is the point in "walking in "for some random blood test at a chemists? No one would have a politician fly a plane or control rail signalling...tragic events result when clinical medicine is taken over by politicians. The UK model is unique,but is now increasingly fragmented, incoherent, jargon laden and inefficient.Sadly itsmore costly with enormous waste of resources.Continuity of care is eroded by misguided political interference.The scandal of wasted funds for administrators, duplicated services,NHS Direct and billions squandered on IT projects.Patients deserve aprofessionally led NHS.

jb, ascot, uk

This is a very sad case that and is very emotive. Clearly the care her was not good enough and lessons should be learnt. But Maria's comments go along with the increasing 'Daily Mail' trend to vilify GPs as either fat cats or incompotent. General Practice in this country provides the best and most efficent care amongst developed countires as recent report stated. In general practice we carry out 260 million consultations a year. We carry out 80% of the NHS workload but get only 20% of the funding. Yes things do go wrong as in this case but on the whole we get things right and people I treat are happy. I am not lazy or incompetent. I have worked so hard to get where I am over the last 10 years, sacrificed a lot, the prime aim for this was to help people. There are lots of things we can improve like extending opening times, which i am sure will happen soon. I am sorry Maria has had bad experiences but she should not brandish all GPs with the same brush.

Dr N Patel, London,

I wholly sympathise with this poor families plight. Having had a similar experience of being double up in pain in the early hours of the morning and speaking to an 'out of hours' doctor who told me to take a couple of pain killers and go back to bed and then being admitted the next day to hospital with appendicitis, I can fully understand this situation. My father also saw three 'out of hours' doctors who dismissed my father as a whinger. It wasn't until 5 days later when he managed to see his 'real' doctor that he was admitted into hospital and diagnosed with a fractured hip joint. This is an appalling state of affairs when your health is left in the hands of someone who really feels agreived at being 'got out of bed in the middle of the night'.

J Davis, Swindon, Wiltshire

The government is intent on fragmenting patient care and separating it into episodes. It is intent on measuring what can be measured and ignoring and devaluing what cannot. Continuity of care is not valued in the current religion of " market forces". This article illustrates how important continuity is. My colleagues and I are becoming increasingly concerned that quality of care will suffer if continuity and commuication in a collaborative rather than financially competitve medical environment is not encouraged. But then I am beginning to think that quality of care is not a priority for the government as long as doctors can be blamed for its failings.

sarah, york, uk

This is an appalling tragedy, and quite possibly not the only one, and proves that the health system in Britain has gradually degenerated into a third-world and not a first-world medical system that should be expected in a supposed advanced industrial nation and the 4th wealthiest in the world. Even with an annual bill, provided by the tax-payer, approaching £90 Billion the system is now incapable of providing medical cover and services outside of normal working hours and not at weekends and definitely not on Bank Holiday weekends. The quite pathetic service provided by sections of the NHS and by phone-in systems as NHS Direct and other fill-in locum services simply do not meet the needs and demands of human beings. Is it possible that a politician, any politician, will get a grip of the medical services provided in Britain and ensure that this tragedy simply does not happen again through a lack of information, indifference or even medical incompetence?

Kenneth Armitage, Suffolk, England

My sympathies and condolances to Mr. Mackinnon. It appears to me that this a clear systems failure. However, equating the NHS with Tesco is missing the point completely. Why not then insist on every other service to open till midnight, eg dentists, inland revenue, DVLA, etc. In fact, why only till midnight? The reality is that resources are not infinite. If the NHS operates like Tesco, then profits would be a priority. So forget a 'free' heatlh service and get ready to pay.

joe bloggs, Birmingham,

None of this is news to me. it is not just out of hours that needs to be looked at.

My wife complained of earache, hot flushes up and down her body. Went to see GP at 9:30am, sent home with antibiotics. Phoned GP at 11:30am as symptoms got worst, GP suggested going to A&E. A&E doctor says give antibiotics 24 to 36 hrs, later says he told us wife had tonsilitis-imposible as she had he tonsils were removed. Called GP at 5pm told to phone ambulance. Ambulance called, she had heart attack in ambulance. 10 hours of talking to medical professionals did nothing for her.

Ricky Aziz, Liverpool,

'Gordon Brown steps in'. Are we supposed to be reassured that the man whose government was responsible for negotiating contacts with GPs that doubled their wages for doing less work, no weekend work and which gave them bonuses for doing all of the health check tests that they should hhve been doing anyway?
With their whopping salaries, senior GPs now have the time to gain expertise in other areas, like honing their golf swings and finding out the best way to invest their money.
Junior doctors can't get jobs because senior GPs don't want them on the gravy train, lowering wages. That's what the market does Gordon. It shafts people unless you control its excesses. New Labour is more 'Soft Mick' than 'Soft Touch' when it comes to controlling private sector greed.

ian, bath,

Treasury did indeed pass the GP contract in 2004 but the alternative was a mass exodus of GPs who wanted normal working hours and are self-employed (unlike Tesco staff)

Muqbool Khan, London,

I stopped doing out of hours several years ago but after the New GP Contract was introduced. - One is put in an impossible situation. One is exhausted already before you start from 60 + hours daytime job, the system is underfinanced and therefore understaffed and overloaded and continuity of care hopeless. Simply not worth putting your licence to practice at risk. Watch now how the numbers of GP's doing out of hours goes in to freefall.

A GP, London,

How is it that a charity or club for children is obliged to make a risk assessment for the safety of the children in their care, when government health officials can authorise a private company with such basic common sense failings? If a similar risk assessment had been carried out these flaws would have been apparent.

Andrew Collier, High Peak, UK

who are the chief executive and managing directors of Camidoc and will they resign along with all the doctors and go and do work more suited to their casual approach

Robert Eric Percival, thetford ,

I have the upmost sympathy for Mr MacKinnon and his son, for their tragic loss, which should not have happened. However, for discussion:
1 GP's salaries have not been doubled. The average experienced GP now earns in the region of £80,000 in line with that of a consultant,for working 60+ hours per week; for providing the usual and specialist services which ease the strain on the main hospital services. No media clamour has been made of the nil increase (effective pay cut) in GP salaries this year!

2 The GP surgery is not equivalent to A & E. Many patients believe that they will be able to have all the tests carried out by the GP that they could with A & E. They cannot. GPs have limited testing services which take days to return results.

3 General Practice is now a job, not a profession (is any!) since the collapse of any respect, linked to a massive increase in unrealistic patient expectations.

4 "Checkout" medicine will end all goodwill - expect to be a simple number

AJ, England,

After 30 years, our practice reluctantly gave up out-of hours provision recognising the risks to patients that this case so tragically demonstrates.

Reasons were not purely financial but our availability at evenings from 6pm-8.30am,365 days a year was costed at £6000 and made no business sense and placed poor value on our service. It was not the fact that this was all we had to 'give-up' to discontinue.

To continue providing the service under new regulations we would have been required to introduce 'call answering standards and equipment' Installing this in each of our homes was a further barrier. (A doctor/car and wife answering a phone was the 'service')

Practices providing out-of-hours care are unattractive to younger colleagues wanting a better work-life balance. The increasing trend towards part-time and female colleagues with young children confirms this perception. They are the future GP workforce - You would need to ask them whether they view it as a job or a vocation.

Local Doctor, Fylde, Lancashire

There exists some problems with patiants compitance. All GP's must talk with patiants on the first step of deases. In Russia we have a lot of similar case. Patient must know all about his organism, treatment and future results.

Mikhail Lavoshnikov, moscow, russia

Primary care through GPs, out-of-hours walk-in centres or other "eye-catching" health care initiatives would be a joke, if it wasn't so important and relevant for people's lives. The NHS has been reduced to an excellent provider of health care for extremely rare or complicated conditions at some of the best specialist hospitals in the world, but the quality of primary care for low-risk or middle-of-the-road illnesses is a disgrace. To give an example, my daughter is six and has grown to this age without ever seeing a paediatrician at the NHS (the GP refused to refer or the waiting time was several months). My continental European friends from France, Germany, Greece etc find it hard to believe it. What is needed is a generous tax break or vouchers for those opting for the private sector (so that they don't spend twice for health care). This will enable everyone, and especially millions of middle-class families, to escape the third-world standards of primary care at the NHS.

Tim, London,

'Be careful what you wish for.....Civil Servants & politicians have wanted to break the medical profession's perceived monoply for decades and the new GP contract was part of this strategy. They removed 24 hour responsibility in exchange for the profession accepting more widespread private sector provision in the NHS, but the unintended consequences include fragmentation of service and the loss of the vocational ethos that comes with granting a degree of autonomy to independent professionals.
In this sad case, GB talks about access but seeing or speaking to a doctor was not the issue here although the standard of care & service design clearly was.
I have total sympathy for the husband but the comment about Tesco's is just plain wrong. A supermarket charges customers directly for goods & services, a GP cannot.
One more thing. The GP contract was performance-based, hence the extra money was earned not gifted, and its all being clawed back anyway - 0% pay award 2 years running

Jonathan, Bath, UK

How tragic, That someone should die from such a basic inter op. I feel for the family

nicole, london, england

"GPs in this country are not well trained and they seem to know very little about medicine. In continental Europe GPs do not constantly refer people - they do know their ‘trade’"
Maria, Manchester

This is because doctors and other health service staff in other European countries have not been imported in job lots from third world countries. Many can barely speak English. Result - chaos, incompetence, negligence, etc.
The same can be seen in many other nationalised and private services.

Steve, Sutton Coldfield,

I work as a GP in Camden and also work for Camidoc. Camidoc provides an excellent service the vast majority of cases. Most of the other GP working at camidoc are experienced, hard working doctors, who also work in the local area. This case, though regretable, highlights the difficultly in diagnosing a rare and unusual presentation of aninfection. This woman did have access to health care - she consulted a GP eight times in four days. Very few other countries provide such an open access of health care. If all GP's were to work like as suggested by Penny Campbell's partner from 8am to midnight, 7 days a week like "Tesco's", surely there would be more mistakes!

tina, london,

I worked as a hospital physician for several years before leaving clinical medicine. The apparent standard of care Ms Campbell received is sadly reminiscent of that I myself witnessed. In some cases this is due to a lack of knowledge and experience - GPs can practice having been exposed to a minimum of acute hospital medicine, in which case they will be ill-equipped to recognise potentially life-threatening pathology. In other cases some doctors seem not to care enough that they are dealing with people's lives and health. That may be a flaw of the medical school selection procedure, with too much emphasis on academic ability and too little on a compassionate personality. It is unequivocal that cases like Ms Campbell's occur much more frequently than the public realise, simply because many patients and their families are unaware of what actually happens. Mr MacKinnon is quite correct regading the lack of accountability in the health service. I wish him success in his fight for justice.

S.Dissanayake, London,

The number of medical negligent acts in this country must beat all the records in the developed world! I believed that problem is: GPs in this country are not well trained and they seem to know very little about medicine. In continental Europe GPs do not constantly refer people - they do know their ‘trade’, and one is only referred if the case is really serious. This takes the pressure from the services further down the line, which can then concentrate on more serious illness, and it also reduces the financial pressure on specialist health services. All GPs do in this country is prescribing anti-depressives and referring people to other services, and in many cases not even to the right specialist services…

Maria, Manchester,