Decades of political incompetence are to blame for this latest NHS crisis

SIR – The NHS is in crisis because of incompetent planning and management.

Successive governments have insisted that beds should be closed. The country does not train enough nurses and is reliant on other countries for them. NHS staff have been penalised by pay freezes, while profligate waste continues unchecked.

Cancelling “routine” operations (report, January 3) will have no effect. The staff involved in these procedures are not trained to care for emergency medical cases, and most will simply be paid to do nothing.

Successive ministers of health are the ones who should be apologising for their failures, not some poor beleaguered A&E consultant in Stoke. David Nunn

Port Isaac, Cornwall

SIR – With winter pressures in mind, it would be useful to see how many of the acute NHS hospital trusts in England have built in contingency plans with the independent sector. If acute trusts worked more proactively with the independent social care sector, in many areas those winter pressures caused by delayed discharges could be eliminated. Professor Martin Green

Chief Executive, Care England London E1

SIR – The dire effect that the seasonal rise in respiratory viruses has had on the NHS admission system demonstrates serious flaws in its central command strategy for managing “winter pressures”.

Britain has the lowest provision of acute medical beds in Europe, with bed occupancy in medical specialties at around 100 per cent for most of the year. The bidding process devised for acute hospital trusts to secure “winter pressure” funding diverts resources into high-cost temporary beds, compromises clinical quality and fails to tackle the root of the problem.

Perhaps 2018 might be the year to end wasteful short-term cash injections, adopt a more realistic appraisal of the limitations of community services, accelerate access to effective social care, and establish a bed base for medical emergencies that avoids the indignities of overcrowding. John J Turner FRCP

Liverpool

SIR – The Government must recognise that the NHS is too big to handle effectively. What is needed is the decentralisation of medical services involving the creation of large autonomous districts. Gordon Galletly

Halstead, Kent

SIR – Temporary deferment of non-urgent medical operations and increases in rail fares are both rational responses to increased demand on parts of our national infrastructure.

Until people are prepared to pay the full economic cost of Britain’s medical services and rail network, we must tolerate these recurrent “crises”. Michael Heaton

Warminster, Wiltshire