HAVING read the lead story and editorial on 'super surgeries' (Bolton Evening News, December 29), I was very saddened to learn that the current GP system is 'outdated', as suggested by both your leader writer and Dr Kevin Snee, Chief Executive at the Bolton Primary Care Trust.

While there may indeed be some surgeries in the town that, perhaps through their adverse geographical location, have been unable to expand to meet the requirements of modern practice, from my experience the majority of general practice premises, including our own building, have benefited from the generous grants available over many years, and have expanded periodically to accommodate the increasingly broad spectrum of services we provide on site to our patients.

Indeed, the only major brake on continued expansion and modernisation is the withdrawal of individual practice improvement grants by the current NHS administration.

I have practised at Spring House for over 25 years. My partners and I run a medium-sized practice with a large proportion of elderly patients who are used to a service where each partner has detailed knowledge of each patient on a personal list. We are also conveniently located for the majority of our patients. Having discussed the 'super surgery' proposals with patients, there is no question that the overwhelming preference would be for the continued existence of the local and personal services that we strive to provide.

Larger purpose-built centres are to be welcomed in areas of community health services need, which clearly exist in our town. However, I think it is a scandalous waste of resources to draw up plans for 'super surgeries' in areas which are already serviced by modernised and well located surgeries on which considerable outlay has already been expended through health services grants and personal investment by the practices themselves.

The mission statement of this administration is patient choice. Would Dr Snee care to canvass our patients for their views on delivery of community health services in the future? Small is beautiful and promotes healthy competition between neighbouring practices, giving patients the opportunity to register with the practice of their choice.

'Super surgeries' with their one size fits all, and built on a scale as envisaged by Dr Snee, will depersonalise primary care, decrease patient choice and remove the entrepreneurial stimulus to improvement as exists at present. They will also, at £64m, consume a vast resource that could be spent directly on patient care.

Dr I G V James

Chapeltown Road

Bromley Cross

Bolton