Continuity of care in general practice

To the Editor: I thought it most appropriate that you juxtaposed the articles by Kilmartin et al1 and Fitzgerald2 in your General Practice issue (15 July). Missing from each article is a key aspect from the patient's point of view.

As a patient, I value, above all else, continuity of care by my general practitioner. In this age of increasing sessional work (by both female and male doctors) and of increasing employment of doctors on a sessional basis by corporations, this feature of general practice is threatened.

As a former GP, I am increasingly being asked to comment by lawyers (for both plaintiffs and defendants) on cases where patients have fallen through the cracks that are an inevitable aspect of sessional care. Patients are being seriously harmed because of poor communication and poor or no handover between sessional doctors.

What is most disturbing is the absence of failsafe mechanisms to ensure that communication, both verbal and, more importantly, written, between the sessional GPs in a practice comes as close as possible to providing the continuity of care offered by the now nearly obsolete five- or six-day-a-week and after-hours family doctor.