Steve Ainsworth (Yorkshire terrier, page 22, 9 March) is being deliberately controversial when he suggests removing all disciplinary and complaints procedures from health authorities and giving them to the General Medical Council. It would be ridiculous for the bodies GPs contract with to have no powers over those contractors or the service they provide.

Mr Ainsworth confuses the detection of criminal activity with the management of poor performance.

Doctors' accountability will not be improved by centralising regulation with the GMC. The GMC is there to ensure doctors are capable of practising to an accepted professional standard.

The HA needs to have powers to ensure doctors have reached that standard, and the teeth to be able to tackle poor performance where it occurs, in partnership with the doctors themselves and other stakeholders. Developing robust clinical governance structures and locally agreed procedures for dealing with poor performance should ensure this.

Dr Diane Reeves GP medical adviser Sandwell HA