LettersPMS pilots

I turned to the feature 'This is your pilot speaking' (pages 30-31, 3 August) eagerly hoping to find some clear, explicit information on personal medical services pilots and was disappointed.

The reported evaluations appear quite superficial and particularly avoid reporting on any sort of economic analysis.

Especially with the NHS plan and its commitment to forcing the pace of change from general medical services to PMS contracts, my colleagues need to be able to understand exactly what the change means. Rumours abound that current pilots are being treated financially in a preferential manner.

How are the premises being provided and funded? How are practice staff needs being funded? At what rate are the salaried doctors being paid and where is the accounting for out-of-hours services, holiday cover, maternity leave etc? The questions go on and on.

It certainly appears that some high-profile pilots have excessive staff and income for caring for very few patients. Is it true that practices are being given 'development money' to fund totally the cost of extra GPs and practice nurses irrespective of other local practices needs?

The answers to these questions may be perfectly straightforward when some established GMS practices convert, but the answers are certainly not clear always.

There is a need to understand what the change is doing to individual doctors' incomes and how the capital assets of practices, mainly in the form of premises ownership, are affected.

It is to be hoped that the lessons of the start of fundholding have been learnt. Creating a group of practitioners who believe themselves to be discriminated against will not advance quality general practice.

Malcolm Fox General practitioner Macclesfield Cheshire