As a late middle aged GP the new contract meant that I could continue with my career, as the open ended commitment meant a workload increasing to unmanageable proportions. As it is I am at my desk at 6.30 am every weekday and work until 7pm. I am afraid to say that at least 3 hours of that time is completing paperwork and feeding the computer.
A large prorportion of the GP workforce is now part time with a limited commitment , often due to childcare duties. I am afraid that the days of DR Findley being available round the clock are gone forever. Any attempt to revert to the old contract will I am afraid be met with mass resignation.

G peckitt, rotherham,

A tragic case and previously a simple review [after one telephone call to the ward ]by the surgical team involved would have identified he problem..

Also as a general principle -70% of diagnosis from 'history', 20% from 'examination' and 10% from 'investigation'
Highlights danger of only having telephone triage systems without ability to visit patients -would therefore anticipate significant further cases like the above

mark r palmer, Lower Brailes, Oxfordshire

I think that the doctors should either be struck off for gross misconduct. There should also be a central database where information like needs to be collated, and any doctor not conforming to ensure excellent (because that is what we should expect) care should be registered and monitored!!

shirley, london,

my father saw 3 doctors and we then dialed 999 and when taken to the hospital said he was showing all classic signs of a heart attack and if they had got him sooner they could of saved him. I then found out the first Doctor who saw him had his own practice, was doing out of work and running a nursing home!!!

june Hart, Hockley , U.K. Essex

Septicaemia is a rare but recognised complication following injection of haemorrhoids. Hospital surgeons who carry out this procedure are fully aware of this possible adverse effect. However, it is unfair to expect GPs to diagnose this compllcation when they rarely encounter it. I believe the patient contacted the hospital surgeon who carried out the injection but was obviously fobbed off - a classic case of dumping. 'Dumping' of patients happen very frequently and the blame is usually and unfairly put on the last doctor who saw the patient.

john smith, warwick,

This is nothing new. I gashed my leg, had it stitched up in hospital only to have it go "hard" over the weekend. It turned out I had gangrene, and I could have lost the leg. I spent ages with a large wound being slowly padded with gauze - all because the local doctor wouldn't see patients over the weekend. The health care system in this country is appalling, and has been for a long time. I originally come from Australia. I’m always amazed at English people who proudly boast that the Health Care system is the envy of the world. It is not.

Shaun OKane, London, London

"By sacrificing just £6,000 a year of income GPs could spare themselves all the bother of calls at night and at weekends": no doubt doctors could recoup that and possibly more by taking part in various public health iniatives, so that it was hardly a sacrifice, but a clever move by the medical profession to get more money for easier- and possibly less- work.

Shakeel Ahmed, Birmingham,

General practice _is_ a job. While it is clear that the out of hours care provision badly needs re-examining, at the end of the day, health care is a service provided by professionals. Something more important is on the line than in most jobs, agreed, and it is fair to require greater commitment of healthcare professionals. However, calling for the medical professions to return to the sheer abnegation of their families and personal lives last seen in the previous generation is absurd. Such a sacrifice may not seem quite so admirable when you consider how many of your friends' lives - or even your own - were shaped by absent parents. There are ways other than envisioning GPs as nuns to solve the problem of out of hours care.

Medicine is a job; it is a job that will not be done properly by burned-out staff, and if its legacy is essentially abandoned spouses and children, then that burn-out is even less worth it.

Jo Shepherd, Edinburgh, UK

In most areas, out of hours care is provided by the same organisations as before - so the failings lie with Camidoc's records system, not with the contract.

It is true that the government has imposed new contracts designed to turn medicine from a profession to production-line shift work - which will suit routine patients well, bur repeatedly fail rare and exceptional ones like this.

The standards set for OOH care (answering the phone within 30 seconds etc) made it impossible for most GPs to continue to provide 24 hour care themselves, and forced us to opt out. PCTs are, in turn, cutting funding, reducing services, and contracting-out to private providers (like SERCO in Cornwall) that routinely fail to meet their agreed targets. In our area the number of GPs on for the county overnight will have fallen by 50% since the new contract was devised, and I imagine health authorities across the country are making similar short-sighted savings.

This is government policy, not GP choic

adam pringle, telford,