Guardian: “He pointed out that the former prime minister’s abnormal heart rhythms could today be treated by using the telephone to measure the heart beats and give an instant diagnosis, followed by a call from a nurse advising on whether the patient needed to “go to hospital or not”. “You could cut dramatically the number of hospital admissions like this.” ”

This worries me badly. What nonsense: this is the kind of thing that primary care doctors, like me, with knowledge and experience can and do manage every day. We know the person’s history, medication, allergies, and often have information about family and local issues as well as the best local route to investigation and management. We can examine the person, take the blood pressure, and make a working diagnosis; how on earth is this improved upon by a telephone nurse advice line? This is what I’m trained to do; GPs should be there, not out of the office on commissioning boards.

Time again politicians refuse to pay attention to the value of face to face patient care. If you don’t get your initial assessment right, everything else will fall apart. That’s why you should put your best, your most experienced and your most capable person there.

The disdain shown for the interaction with doctor and patient, straight off, is worrying. If you don’t value this, what else don’t you value?

The Guardian report that thousands of services will now be opened up to ‘any qualified provider’. The only thing that more competition for services has brought me, as a GP, is a change in how many times different organisations can report that the buck doesn’t stop with them.