Dr Andy Jones writes on the reality of best value primary care and seems to conclude that clinical engagement is the key. However, it is unclear where the best value is to come from and in particular the role that he envisages for GPs and their teams.

Dr Andy Jones writes on the reality of best value primary care and seems to conclude that clinical engagement is the key. However, it is unclear where the best value is to come from and in particular the role that he envisages for GPs and their teams.

He apparently feels GPs are currently 'in the wrong political place', but equally seems to suggest that the items on the 'tasking list' should be offered in 'wider primary care' rather than general practice.

Many of the items, and possibly others, seem to belong in general practice if the hopes of patients and the realisation of the benefits from the new contractual arrangements are to be met. If that is what he means by clinical engagement, I would strongly support him.

There needs to be active engagement of patients, managers and clinicians to ensure the investment in, and the full potential of, general practice is to be exploited. Such a 'can do' approach seems to be an appropriate political place.

It should also answer Dr Jones' 'hovering question' in favour of championing primary care.

John Toby, GP and independent consultant in primary care