Wanted: courage to admit the NHS is broken

SIR – How long will it be before any political party has the courage to admit that the NHS model of healthcare is broken and needs to be replaced?

Acute care needs to be separated from elective care, both functionally and physically. The two cannot coexist using the same resources.

Local health service management needs to be replaced by national health service management. The internal healthcare market needs to be removed, along with its associated management structure, and private healthcare facilities need to be used collaboratively. Dr Frank Booth

Exmouth, Devon

SIR – You state in your leading article (January 4) that “even so radical a reformer as Margaret Thatcher dared only to tinker with the structure

[of the NHS], introducing an internal market and management reforms”.

These changes resulted in a massive

increase in managers, who, in the view of many medical staff, are not simply an expensive irrelevance but actually impede the smooth running of the service.

The problems of the NHS are many and diverse but Margaret Thatcher’s attempt at reform, in my view, is as responsible as any for the service’s present parlous state. Nigel Dwyer FRCS

Solihull, Warwickshire

SIR – Is it too much to expect NHS managers to manage the supply and demand within the service by forecasting likely demand over the year from data available and allocating resources accordingly?

In other words, don’t plan for non-urgent operations to be undertaken during the same period that large numbers of flu cases are expected. Michael RA Shute

Bradford on Avon, Wiltshire