Six years as a GP principal in Greenwich leave me in no doubt that the pressures on primary healthcare services are rising. The London Initiative Zone was welcome, and many - patients and staff - have benefited from premises improvements ('LIZ: a legacy for London', pages 24-27, 1 October).

Some of the less visible opportunities afforded by LIZ have had a significant impact on the skills and morale of GPs who have taken them. The LIZ educational incentives programme has been a crucial fillip to many GPs wearied by the constant struggle against the tide of rising demand and the strengthening undercurrent of dissatisfaction. The paybacks to the service have been measurable across the capital.

The LIZ legacy must be preserved and enhanced through further initiatives, imaginative innovation - with the necessary flexibility of approach - more investment and wider involvement.

Whatever the colour of government, London cannot benefit from short-termism. We have deep-seated problems relating to poverty, demography, recruitment and resourcing. We need deep-seated, long-term commitment to finding solutions that will endure.

Karim Jan-Mohamed

Vanbrugh Hill Health Centre

London SE10