Testing is populist. Discussion how to go from the current annual appraisals to something more bureacratically digestible has gone on for 5 years or so already. The implementation may give us all interesting times. Harder, but more beneficial to those who use it is improved provision of knowledge

adrian midgley, Exeter, Devon

What information about doctors will we get? Patients choose their hospital using "Choose 'n Book", The bit where they choose the doctor has mysteriously disappeared. Those in the know would like to select the best doctor, and let them select the best hospital. I wonder why they can't

Dr Douglas Newton, London,

I would feel a lot happier if politicians were made made to sit a competency test. I mean, they only run the country.
I'd rather trust my doctor than any "quack" politician.

Leo, Durham, England

If you are dissatisfied with your GP's diagnosis, just wave a cheque book under his nose. He'll be on that phone, and in two days you'll be seeing a specialist. It's worth a couple, or three, hundred quid to have your mind put at ease, isn't it?

Dwight Vandryver, Scholar Green, Cheshire, UK

The irony is that many Consultants like myself agree that had the current appraisal system existed in Shipman's time, he would probably have sailed through. Remember all his patients loved him!

Dr I Khan, aberdeen,

As an HGV driver I am assessed on a regular basis,at each depot I have an inch thick manual which I have to digest for the benift of myself my collegues and the public at large I adhere fully to all UK&Euro directives daily.This makes UK truckers the safest, not much to ask doctors to do the same

Dave Farmer, Broxbourne, England

Do barristers, high court judges and journalists have to sit knowledge tests to be able to continue to work every 5 years or have their work commented on by annonymous website postings? Sites such as Amazon show that either the very unhappy or the very contented tend to post making assessment hard

sdr, birmingham,

If Harold Shipman had been a HGV driver would the government insist that there should be more stringent HGV exams?
Harold Shipman was a serial killer that happened to be a doctor.
There is a huge difference between legislating for incompetent professionals and trying to stop a serial killer.

Ben Walker, Leeds, UK

My GP husband is using time writing to convince the PCT to suspend his incompetent fellow-GP, b/c having looked at the inch-thick dossier of malpractice that he spent a year compiling, they said since all his missed diagnoses were picked up by s/one else & noone died yet, he's not a severe risk!

Amanda, London, UK

As a medical student I find the current climate disheartening. The consultants whom I see are increasingly dissatisfied with the level of pointless, time-wasting bureaucracy imposed. Subjecting doctors to intense targets and now potentially anonymous, paranoia-driven criticism will not help.

Haris Ahmed, Woldingham, Surrey, England

The misery of New Labour orthodoxy - even if there isn't a problem let's pretend there is - so we can set targets, reform yet again the existing structures, form new bureaucracies to divert time and resources from useful activity
will the, now almost inevitable, new Tory Government be any wiser ?

John Moir, Glasgow,

Thankyou for a balanced article.
Like many in this profession, I daily balance the challenges of the job with limited resources , as you point out, and it is a real reassurance to know that there are people in Britain who understand the constraints of the job, and aren't off to join a lynch mob! Ta

Dr Jessica, wrexham,

Frankly "choice" is an urban obsession - in rural areas we have often only have one practice that will accept you as a patient, and little choice over who you see unless you can wait for another day. Combined with the loss of hospital services we are just pleased to see anyone without going too far

Peter, Midhurst, West Sussex,

Great GP care now outside my area 100% care in London with GP's 100% praise.However 4 years in the middle bypassing services and overusing casualty including taking infections into hospital 0%.Complaining = bullying,erosion of community and less funds for the good guys.Chief exec's = 0%.Whitehall 0%

mary foord brown, suffolk coastal,

Things will only get worse if the government imposes an even heavier bureaucratic burden on Drs, they'll get even less time with their patients and seems to me, as a medical student, that in patients eyes time equates to quality. It sounds great to the public, but in reality Shipman was an exception

kate, London,

A system for ensuring ANY healthcare professional keeps up to date and competent in their field is clearly sensible. Implying that it will catch the (very) occasional Shipman is completely stupid. Even stupider is implying that patients know what makes a good Doctor.....

Phil, Lancaster, England

The simple fact is that a doctor who qualified in the early 1960s could still be practising today without a single check over that time that s/he is keeping up to date etc. These proposals don't go far enough as they don't involve thorough 5 yearly exams. Also, use http://www.iwantgreatcare.org

Clint, Brighton, UK

Nurses and midwives already have to go through this rigmarole. They soon became adept at ticking the right boxes and playing the game, but it was just one more administrative chore that this government insisted upon so that it can appear to govern.

ABH, Nantwich, England

We already have 7 regulators costing us £755m a year to oversee the NHS. As they are overpaid and ineffective, we're going to waste hundreds of milions more on even more bureaucrats and regulators - what a disgrace!
David Craig
Author "Squandered: How Brown is wasting over £1 trillion of our money

david craig, Bournemouth, UK

lets all quit and go abroad.

wendy, luton,

The Government, the GMC and Liam Donaldson set up and ran MTAS with the Royal COlleges. Get real boys, would you trust them to manage your future? And anonymised evidence to "root out" bad doctors unchallengable, and illegal? Shameful!

Danny, Manchester,

At last, something good as come from Shipman report and public be confident that they will have excellent GPs and have patient value being key focus. Now let the public see it happen in practice and not b a public exercise and tick the box system.

Harrison, london, United Kingdom

Well, I'll quit and do something else. The job isn't worth it any more.

Rory, London, England

It is not doctors who are a fault: it is the cleaners. I was in a spanish hospital: where the wards were cleanes every hour.The cleaner came in, cleaned around my seat, then said; *I am cleaning this room, if you move in the next 10, minutes there will trouble. the room was cleaned. pride

dave badger, valencia, Spain

That is a fair article, a rare find in today's 'doctor-bashing' media.

Dr S Patel, Melbourne, Australia

The Government, the GMC and Liam Donaldson all say that doctors cannot be trusted. Which is odd because most of the public disagree. On the other hand most doctors mistrust those three agencies intensely, and with good reason. So thank you for your supportive comments.

Dr Michael Leuty, Nottingham, UK