DR Hamish Maclaren’s ideas for GP and community care may be an ideal kernel (Letters, November 8) of an overall plan for the NHS in Scotland, any plan for which we have had recently acknowledged by the Scottish Government as being years away.

However, what he may not have considered is the positive effect his ideas would have on the acute hospital sector and particularly A&E waiting times and the number of cancelled elective operations, both of which are regularly highlighted in The Herald. The Government mantra of “there are thousands more doctors in the NHS” is indeed reflected in my previous hospital A&E where consultant numbers have increased from three to 12, yet waiting times remain unmatched. The problem is not in A&E but in the downstream limited number of acute beds for the frail and elderly, often disparagingly termed “bed blockers”. Similar lack of beds prevents admissions for operations which are cancelled regularly.

Acute hospitals are no place for those suffering from the inevitable consequences of age and infirmity, and who require simple care and attention, not highly technical and expensive medical care, which is often fruitless. Dr McLaren’s “back to the future” idea of community hospitals run by GPs and nurses is a development the NHS must reconsider. Not only would the care be more appropriate for patients but the work may be more challenging and interesting for some independent GPs with special interests. I am sure communities, and the third sector, would welcome a return of their local small hospital. Widespread closure of care homes has exacerbated the problem.

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If one looks far enough ahead the days of the acute general hospital are numbered. Most surgery can be day case so in-patient bed numbers can be cut proved operating theatre numbers increase, and more complex care is better provided in the such as the Queen Elizabeth University Hospital or the royal infirmaries.

I have recently suggested that the replacement of such an acute hospital in Monklands at a cost of almost £500 million will be a folly. Reorganisation and refinancing of the GP services, and three or four new community units throughout Lanarkshire would be a far better way to spend such sums. Here is the ideal opportunity for a pilot.

If only the health board, Health Secretary and the Government had the imagination and initiative to think radically. Given the Government admission of “we have no plan” I do not hold my breath.

Gavin R Tait,

37 Fairlie, East Kilbride.