The response to your editorial (''Fees a bitter pill'', August 28, p24), by Dr Philip Barraclough (Letters, August 29) contains a number of inaccuracies and misleading claims. However, the argument that everyone who sits in his waiting room doesn't really need to see a GP is spot on. This is not, however, because these people are malingerers who do not need care. Rather, it is because the range of skills that GPs have is extremely narrow while the range of needs that patients have is extremely broad. Doctors are part of a medical care system, trained to provide medical services.

We need medical services but we need a whole range of other counselling, information, education, caring and support services that general practitioners are not trained to give and don't have time to give. It is not the fault of GPs that complementary services are not provided by our health system, except in the sense that the medical profession has relentlessly and vehemently opposed the establishment of any kind of health service, such as school health, baby health and community health centres, for fear real health services might impinge on the medical marketplace, resulting in fewer clients.

It is certainly true that for many people a visit to a GP is a waste of taxpayers' money many people come away with their dietary problems, anxiety and depression, for example, undiscussed. The violence and unhealthy habits in their lives probably remains undetected. The preventive health services that people need are in very short supply indeed. It is nothing whatever to do with markets or price signals. Further it is misleading to claim that the Medicare rebate for a GP visit has been out of touch with the real cost of a consultation for many years. Bulk-billing in the ACT is the lowest in any jurisdiction and has been so forever, no matter what the level of Medicare rebates.The Howard government stuffed the mouths of GPs with gold in the two years prior to the 2007 election to ensure that bulk billing stayed at a reasonable level and public outcry would be muted. If the rebate is paltry, as Dr Barraclough claims, I wonder what level of income he thinks befits a so-called ''private practitioner'', who is free to charge as s/he wishes but who gleans well over 80percent of income from the public purse? Maybe it's about time that GPs thought of taking salaried jobs as they are doing increasingly in other countries (and in the corporatised medical sector in Australia) giving up the pretence of being in ''private practice'' but nevertheless earning a decent and secure income like all the other members of our community who are paid at public expense. Then we wouldn't need Medicare, the system he sees as such a failure, anymore. Only insistence on retaining the 18th-century cottage industry of private practice makes Medicare necessary at all.

Gwendolyn Gray, Deakin

Disgrace all round

The conduct of Ray Newcombe the neurosurgeon who left a surgical instrument in a patient's head and then covered it up for 10 years is disturbing (''Neurosurgeon ordered cover-up, tribunal told'', September 3, p1). And this appears only one of 15 cases where Mr Newcombe made major errors.

While his conduct is a disgrace, it is also a disgrace to his colleagues who knew that he was not fit to practise and yet did little about it. Presumably these colleagues complain when the medical profession is criticised by the public, and yet it is their sticking their head in the sand over these issues that leads to criticism in the first place.

However, Mr Newcombe's colleagues are only human. No doubt many are aware of their own mistakes and are therefore unwilling to point the finger at one of their colleagues. Secondly, in medicine there appears little culture of reporting colleagues and we all know what it can be like to rock the boat. The challenge, then, is to change this culture. One good place to start is by looking at the aviation industry, which has a well-developed culture of looking at human error and working to eliminate it. Complaints can be lodged confidentially to the Australian Transport Accident Bureau and pilots who start behaving recklessly are a recognised problem. If the medical profession is really a profession it would realise the damage that reckless, careless and unskilled members do to its standing in the community, let along the community itself, and work to change that.

Sally Franklin, Aranda