I must respond to Sophia Christie's column. The days of the GP doing an ever-expanding range of tasks for the same money are gone. Movement from secondary to primary care must be accompanied by altered funding flows.

Practice based commissioning should be a prime mover in this, and enhanced services the funding vehicle. The existence of a national enhanced service for care of the homeless recognises that such activity is outside core GP services and requires additional resources.

Taking advantage

Many primary care trusts have willingly taken advantage of this, so it is difficult to see why Ms Christie seems to want to regard it as part of core services.

Her reference to "Xp per patient" is odd. Why was the actual figure of£56.20 per Carr-Hill formula weighted patient not quoted?

GPs cannot be criticised for not performing some tasks under core funding when the value of X is undeclared. If a PCT wishes to purchase from GPs activity that once went to hospital, X needs to be increased or supplemented by enhanced services funding.

Dr Paul Roblin, chief executive, Berkshire, Buckinghamshire and Oxfordshire local medical committee