Letter: NHS winter woe

Sir: The current winter crisis, a repetition of problems that occur year after year in the health service, has created huge problems for overstretched general practitioners, community nurses, ambulance services, accident and emergency departments and hospital services, including intensive care units.

There are many causes for the latest crisis, including viral illnesses, inadequate hospital and intensive care beds, a shortage of nurses, and underfunding.

It does not help, however, to make unfounded assertions that general practitioners have not been there for patients who need them ("Casualty ward is `bursting at seams' ", 6 January). GPs are obliged to provide care, personally or by delegating their responsibilities to a deputy, an out-of-hours co-operative or a deputising service, and there is no evidence that they have been failing to meet their obligations.

I am not at all surprised that the accident and emergency department at St James's University Hospital in Leeds has been extremely busy over the Christmas period and that its staff have made heroic efforts, but I know too that Leeds general practitioners will also have been working exceptionally hard, just like their colleagues all over the country, responding to public demand.

Dr J W CHISHOLM

Chairman

General Practitioners Committee

British Medical Association

London WC1