We write in response to the letter from Mr Oliphant (September 5) in which he commented on the practice's recent decision to ask 300 patients to re-register with a more local practice.

We have asked these patients to re-register for a number of reasons. In particular we consider it important that patients can be visited quickly in an emergency, that the practice's overnight on-call doctor remains as far as possible within our practice area, and that patients needing district nurse care receive it from district nurses attached to their own practice (which is not the case for patients living outside the practice area).

There is now a significant shortage of GPs in this country, nd the workload of doctors in general practice is increasing.

Work that hospitals used to do is being passed to GPs particularly through patients being discharged sooner and ever-more detailed standards for the treatment of chronic disease (for example, the new heart disease clinics we have now) are being, quite rightly, required of us.

There is also the pressure of providing 48-hour access, which requires increasing amounts of GP time.

Therefore, we consider that it is essential that we make the best possible use of our time.

We consider that it cannot be efficient for us to be making visits to patients living in Pewsey and Burbage and beyond, for example, when they can much more easily be visited by doctors based more locally.

Admittedly, it is true that some patients have less choice of practice than others because of where they live, although generally most people are able to choose between a number of local practices, or at least between a number of doctors in their local practice.

We regret very much that it has been necessary to ask any patients to re-register, especially some who have been with the practice for many years and we understand many patients are reluctant to have to change doctor.

However, the situation has changed very significantly since these patients were first registered with the practice and, as we have explained, we finally concluded, after deliberations over many years, that we are no longer in a position to continue to provide a primary care service to patients living outside our area.

Mr Oliphant suggests that the practice should have been expanded to cope with the increased pressure on us.

Our response to this is two-fold. Firstly, an extra GP would not address any of the four reasons why we are asking out of area patients to re-register. Secondly it is becoming difficult to recruit new GPs.

In response to Mr Oliphant's final point, we would still consider, even if there were more than one practice in Marlborough, that it is important that patients are registered with their local practice so that they can be visited quickly in an emergency.

The partners of The

Marlborough Medical

Practice