Steve Ainsworth in 'Omission to explain' (page 27, 30 July) is absolutely right in stating that the vast majority of patients know full well why they have been removed from a GP's list.
No one expects a doctor to tolerate harassment, abuse or physical assault by patients, and removal of such people is the GP's ultimate sanction.
However, a sizeable minority of patients are totally bemused when a GP arbitrarily removes them without explanation.
I recall one elderly gentleman who had been with his GP for over 20 years, enjoying what he thought was a cordial relationship with the doctor and his practice staff.
He was at a loss in reconciling the GP's action with his own impressions of a long doctor-patient partnership based on mutual respect. He felt it would be difficult at over 70 to start afresh with a new GP. He speculated that perhaps he was 'too old' or that his medication was too costly, and that was the reason for his removal. He clearly did not understand what he had done that the doctor found so unacceptable.
Steve Ainsworth feels that we patients should think of our relationship with GPs as being more akin to solicitors or hairdressers.
I would suggest that this demeans the role of a family GP, which at its best is that of a friend and confidant who looks after our best interests health-wise. If you fell out with a friend, wouldn't you want to know why?
Kingston community health council