Despite Steve Ainsworth's statistic of 'only one person per GP per year', there is a distressingly high incidence of people with mental health problems being removed from GPs' lists.

It is entirely plausible that those with mental health problems may behave inappropriately towards their doctor. If they are not given feedback about this they have no chance to learn appropriate boundaries.

There is an increasing incentive to GPs to remove the 'costly' patient from their lists. There is thus often a double incentive for GPs to abjure responsibility for those with mental health problems - just when the government is realising the problems of keeping contact with them in the community.

Mr Ainsworth notes that GPs are independent practitioners - presumably he thinks they are accountable only to God. The nature of healthcare means that GPs' patients are the most vulnerable people in society. Should there not be checks and balances to protect the most vulnerable from potential abuse by a nationally funded system?

Mr Ainsworth notes that 'in most... cases it emerged that the patients had been less than frank'.

Clearly, both the patient and GP had told their story, but Mr Ainsworth had no problem in applying a consistent ruling that patients were the ones who were less than truthful.

Director

Hammersmith and Fulham Mind