I've just seen a tearful elderly client who went to see their doctor seeking a referral.

The GP said he would send the referral and 'come and see me again' - instead, two days later, the patient got a letter striking them off. Funnily enough, there was no explanation.

It's crude and insulting to patients (and to GPs) to compare the patient- doctor relationship with going to a pub or the hairdresser.

That this could be contemplated, let alone written, by a former primary care manager illustrates the difficulty of getting the issue taken seriously. Health authorities don't want to know, and seem determined to blame 'difficult patients'.

If you don't believe me ask a mental health trust.

These difficult patients are the same ones blamed for being ill and causing longer waiting lists. Goodness, what a lot of trouble they cause.

If only GPs could be left alone to get along as independent contractors and not be troubled by patients.

But then they wouldn't have any NHS money.

Chief officer

Hammersmith and Fulham community health council