Paid to stay healthy

SIR – Doctors are now being given cash incentives not to refer patients to hospital (report, February 28). How much more sensible it would be for a fee to be paid to patients for not consulting a doctor in the first place.

This would remove doctors’ ethical dilemmas and encourage healthy living, exercising, eating less junk food, drinking less alcohol and generally taking more responsibility for one’s health.

I suggest a no-claims bonus, paid on one’s birthday. This would be a modest amount in one’s 20s, rising to a substantial amount in one’s 70s. Such a payment would alleviate the problems of an oversubscribed health service while still providing care free at the point of delivery. Michael Hawthorne

Madley, Herefordshire

SIR – NHS England is advising parents to take young children to a pharmacist instead of their GP if they are suffering from a minor illness, such as a stomach ache (report, February 12).

However, there is a huge difference between advising on medication for a confirmed diagnosis and actually making the diagnosis itself. A few years ago, I had a stomach ache that proved to be appendicitis. This would have been much more serious had the correct diagnosis been delayed. JD Newman

Hinckley, Leicestershire

SIR – The number of NHS managers has apparenty increased by 7 per cent (report, March 1).

Elsewhere, Debenhams, Morrisons, Sainsbury’s and Tesco have all reduced the number of managers in their staffing. It is surely time that the NHS performed a similar exercise. Ian Dain

Selby, North Yorkshire

SIR – The shift of nurses into administration is driven by NHS pay scales, which award a maximum of £28,746 a year to a fully qualified clinical nurse caring directly for patients, and a maximum of £100,431 a year to a nursing administrator whose work is managerial.

The situation is exacerbated by the increasing pressure on clinical nurses working on the ward, caused by the continual loss of their experienced colleagues. Dr Max Gammon

London SE16