I AGREE with Dr Hamish Maclaren Letters, April 27) that the medical profession needs to tell the politicians exactly what should be done to address the crisis in primary care.

Pity his solution is diametrically opposite of what is needed. Far from requiring an additional 1,560 GPs to meet the current workload, we have more than enough. Rather, primary care needs to change the way it is structured and organised with a radical move from the tick-boxing approach of the current GP contract to one based on continuity of care and the building of relationships between patients and their primary care teams.

Such an approach has been shown to produce outstanding benefits in promoting health, reducing unnecessary accident and emergency attendances and unplanned admissions where it has been pioneered as the Nuka system in Alaska, now widely recognised as the world-wide gold standard in primary care.

Our politicians are already well aware of this new approach to care and the recent changes in health and social care lend themselves to its introduction here. Sooner or later the Government is going to have to bite the bullet and start setting up some Nuka-type practices in Scotland to see how the system might be adapted to our culture. At least one practice is trying to do this. We can only wait to see how many Scottish GPs are willing to play an active part in its introduction.

Ian Jones

Westfield Road, Cupar.