AN NHS patient in pain is turned away from her local hospital and forced to travel ten miles for treatment, purely because she is a patient of a certain surgery.

It beggars belief, but sadly it appears to be true. What a reflection on primary care in Wiltshire.

Barbara Smith, the Chief Executive of the Primary Care Trust, attends a meeting with the patients of the same surgery and says that she will investigate. Why does she need to investigate, when her office sets the policy?

We have all read and applaud the respect and feelings Dr Williams' patients have for him but this will not cut any ice with the PCT, at least not while Barbara Smith holds the reins.

The crux of the matter is not the patients' feelings nor their requirements, the PCT will ignore those. They have the power to do so and have indicated as much in their negative answers to recent questions.

It is the GP Pilot Contract which is in question and what the PCT is at great pains to keep under wraps is that it was the party which, knowingly and deliberately, broke the contract in the first place. The contract clearly states that the PCT must consult and offer every assistance to any GP who is encountering problems in delivering any particular part of the services required by the Pilot Scheme.

The PCT have continually failed to consult with Dr Williams about his difficulties, and certainly offered no assistance to him, thereby breaking the conditions of contract.

Barbara Smith not only holds the post of Chief Executive of the PCT but also the position of contract manager for the PCT. This dual role puts her in a very dictatorial position, but it may very well place the rest of the PCT Board in a rather precarious situation when it comes to contract law.

After all the Board does have a collective responsibility.

Barbara Smith came unstuck recently when she took Dr Williams to court over Breach of Contract.

She stated that the case was withdrawn because of cost, which begs the question "Why was the case brought in the first place?" Did she think we would not notice that she was squandering our money!

Over the past months a question has been bugging me. Who is Barbara Smith? Where did she come from? How did she get her job? Who appointed her? What are her qualifications?

I think thousands of other Gazette readers would also like answers to these questions.

The PCT have decided to cover the out of hours provision for Marshfield Road Surgery at a cost, so we read, of five hundred pounds a night. Where does that figure actually come from?

What is more to the point is where does it go perhaps to the out of hours GP co-operative company which consistently refuses Dr. Williams membership?

DON STEEL

Chippenham