Listening to Radio Four recently, I heard an interview with Roy Lilley, a former NHS trust chairman often quoted in the media as an NHS expert.

He said that what NHS patients want is to get into hospital as quickly as possible, get their problem 'fixed', and get on with their lives.

But GPs know that patients fall into two groups. Those for whom there really is a quick fix. And those for whom there isn't. Four out of every five patients we see in surgery fall into the latter group.

It is true that a normally fit, healthy adult who needs a hernia repair or varicose vein surgery wants nothing more than to get their condition fixed as quickly as possible. They are unlikely to care which GP refers them or where the consultation takes place.

But that isn't the case for the vast majority of patients.

Study after study has demonstrated that patients value continuity of care every bit as much as their GPs do.

If patient choice is to mean anything in the modern NHS, continuity should be on the menu.

More importantly, it is also good medicine and good value for money. A recent Commonwealth Fund study said the NHS's family doctor system was key to its high standards of quality, equity and efficiency.

Other studies show that patients not offered continuity of care are more likely to use A&E unnecessarily - and we all know how much that costs.

There is good evidence that continuity enhances adherence to treatment, almost certainly linked to the trust inherent in a doctor-patient relationship.

It also improves uptake of preventive care and supports health improvement.

The reason for all these benefits is simple. Patients are not machines. They are people with unique lifestyles, social circumstances, religious beliefs or a lack of them, income and much more. Considering the interaction between all these factors can determine whether treatments succeed.

Equally, doctors are not mechanics. We are professionals with years of training and experience behind us. Just as the views and choices of patients deserve to be valued, so do those of doctors.

The NHS Alliance believes that continuity should not be traded for access. The truth is that we need both.

The big issues for the 21st century NHS are long-term disease, the ageing population and the growing rate of behaviourally determined disease such as type-2 diabetes, obesity and cardiac disease.

These are all areas where the expertise lies in general practice and primary care.

Valuing GPs is not about being nice to doctors or stroking professional egos.

More even than the quality of patient care, the way that we value GPs will determine how much tomorrow's NHS costs. And whether we can afford it.

GPletters@haymarket.com

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