As a member of my local PPG in Clapham North I am really concerned that after regularly visiting and discussing matters with my practice that they are under cinsidrable strain, both financially and mentally. The number of targets they now have to achieve not to mention punitive fines now for not achieving targets is enormous, the recent re-organisation of the PCT and poor communication and fragmentation of those that manage them is really worrying. I have seen demand increase each time I go there, we need to support our practices more and ensure that they are adequately supported by the CCG and the government as it used to be otherwise there is a danger that we will have to adopt a system of private medicine and lose all our good primary care teams.