SIR - In the last few months, the general practitioner's committee (part of the British Medical Association) has been negotiating with National Health Service employers following the Government's determination to extend opening hours of GPs' surgeries.

The transfer of resources of these extended hours will inevitably detract from existing daytime care for patients.

In his recent report, Lord Darzi has recommended that primary care walk-in centres are established in every primary care trust. These are to be placed in cities close to transport terminals; each will be staffed with three doctors and nine nurses and will cost £800,000 a year to run.

These will go ahead even if the area in question has an adequate doctor-to-patient ratio already. The quality of general practice in Worcestershire is acknowledged to be very high. One has to ask, are these centres really necessary or is the purpose to privatise NHS general practice? Why waste taxpayers' money?

In the 1960s, general practitioners protested about the lack of proper premises which was preventing adequate care of their patients. In 2008, patients face an equal but different threat to their care because of misguided government policy.

These changes are nothing else but the thin beginning of a very large wedge that will sound the death knell of cost-effective high quality of NHS primary care. Only vigorous action by patients and their representatives now will enable us all to step back from the abyss.

DR JAMES RANKIN, Pershore Medical Practice.