MUCH has been written about "out of hours" GP services, and Dr Stefan Slater's pertinent analysis of the 2004 GP contract (Letters, January 12) is a reminder to the background to this deal, when one of the BMA's negotiators Dr Simon Fradd "was shocked and could not believe it when GPs were given the chance to opt out of evening and weekend work for a six per cent pay cut". Of course the nature of GP work has altered out of all recognition since then, and while it is tempting to heap unfettered criticism on the profession ("GPs take the perks but do little to ease the burdens on the NHS", Kevin Mckenna, The Herald, January 13, and Professor John Black, Letters, January 13) Dr Philip Gaskell reminds us (Letters, January 13) that we have a very efficient and comprehensive health care system, now under intolerable strain. General practice has been burdened with multiple bureaucratic and administrative imperatives including its own myriad of targets, and doctors with annual appraisals (in addition to the laudable process of revalidation) which many feel are superfluous and designed to satisfy professional hierarchies, as I know from the medical journals I still enjoy reading. Much of this, as well as routine patient-centred activities, has to be carried out outwith the "office hours" often quoted in the media.

The new, proposed GP contract ("Union fury at 'scandalous' £10k windfall for doctors", The Herald, January 12), is not without its problems, with family doctors in the Highlands feeling completely betrayed by the funding split between them and central belt practices becoming apparent. Sadly it is not possible to turn the clock back to the halcyon days of medical practice as perceived by many of my generation born before the advent of the NHS. However, patients today are understandably anxious about falling ill outwith GP office hours, particularly in remote communities, and as one who reads a wide variety of newspapers, I find many horror stories, usually associated with system failure, which to a doctor are inexcusable. While society has changed beyond all recognition, and the vagaries of NHS24 may have to be accepted, there must be some place for GPs conducting more of their out of hours work within a framework of general practice devoid of unnecessary bureaucratic burdens.

As one who has spent much of his professional life on call, whether on NHS work, in private practice, "moonlighting" in early years, or as a locum in general practice including 20 years for my wife, some of the most rewarding moments have come during work outwith office hours. It would indeed be a bonus if a new GP contract could incorporate this possibility and allow doctors to do what they trained for and no doubt provides the greatest professional satisfaction, rather than having to immerse themselves in bureaucratic trivia at the behest of self-satisfying politicians.

John Sinclair, Retired consultant surgeon, 7 Bridgegait, Milngavie.

GPS are contracted to cover their practice from 0800 until 1800, Monday to Friday in all medical eventualities. Professor John Black’s statement infers that GPs do nothing else other than provide booked surgery appointments. I do not know of which of the two practices in Helensburgh he is a member, but I do take issue with his assumptions. The GP working day starts before 0800, and for a full-time partner, continues well beyond 1800 .

Prof Black ignores the employment and administration of more than 20 employees, reception and clerical, nursing and managerial staff. No consideration appears to have been taken of telephone consultations, the ever-increasing home visits to frail elderly patients in our community, and to emergency consultations, either in surgery or at home, quite apart from the time spent in student teaching, and the necessary continuing assessment required by the Government, and the daily scrutiny of incoming data from hospital laboratories and consultants.

I also take issue with the article by Kevin McKenna. He calls GPs "local entrepreneurs running surgeries like businesses, not required to work weekends, or beyond normal office hours".The fact of the matter is that GPs are running businesses with the care and cost restraints that all small businesses require to do to be successful. I should point out that it was the government of the day that, in the 2004 GP contract, said that it would take over the night and weekend GP work. It said it could do the work for an average of £ 6,000 per GP. It clearly did not appreciate or value the out of hours commitment that had been in place since 1948.

Mr McKenna's idea that GPs should be brought into hospitals to receive "some experience" is an affront to family doctors. How about suggesting that orthopaedic surgeons or psychiatrists get some experience in general practice?

I was employed in the NHS for 38 years, having joined one of the two practices in Helensburgh as a partner in 1975, retiring from practice a few years ago after a very fulfilling working life, including manning a 24-hour casualty service and 28-bed cottage hospital in the town for most of my working life. It is interesting to note that for most of my career, my working hours, averaged over a year, were well in excess of 80 hours per week (GPs are excluded from the European Working time Directive).

Brian Calder FRCGP, 34 Queen Street, Helensburgh.

I DO not know Kevin McKenna. From the tone of his article he probably doesn't know any GPs. He is a journalist, not a GP, so how is it he can make such controversial, sweeping statements about work he knows nothing of? Surely if he's genuinely concerned for patients it's far more important to get his facts right, not compromise on the evidence for the sake of easy headlines.

The knowledge and responsibility laid upon GPs is colossal while currently the average day is 10-12 hours and many then go on to work for NHS24. They are highly skilled in all the medical disciplines and can make quick safe decisions, accepting all the responsibility of life and death choices.

Bashing GPs in this thoughtless way will do nothing to help recruitment which, if he hasn't noticed, is falling, with practices closing, thus costing health far boards more than when the doctors ran them. But what do I know? I'm only a GP, Dr Mary Church, 9 Carnoustie Court, Bothwell.