Changes to primary care organisation suggested by the Confederation of British Industry could seriously damage the system, argues Martin McNicol

In response to Old-style GPs may go the same way as Britain's motor industry, I have read HSJ for many years but have rarely seen a more ill-considered editorial.

That there are problems with the organisation of primary care is not in dispute. However, it is astonishing that you appear to attach great credence to the view of the Confederation of British Industry, a group identified with shareholders rather than customers and not unknown to indulge in special pleading.

You endorse proposed remedies for which there is no evidence base and which are highly risky. They have the potential to establish a demand-led service which, together with potential consequences of a reorganisation of secondary and tertiary care providing rapid transit to specialist care, could create major problems. Even the 'world-class commissioners' that you recently referred to will be hard pressed to deal with them.

I understand that the evidence suggests that the key to successful provision of healthcare is to strengthen primary care, organise it appropriately and put it firmly in control. Do you have some good evidence that the CBI’s nostrum will be effective? It seems more likely to damage further a critical part of the system.