The Daily Telegraph

The NHS cannot survive if it clings to an outdated funding model

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SIR – If the only effect of the Seventies Royal Commission into the NHS was to reduce bureaucrac­y (leading article, February 11), its benefits have been long overtaken by later changes.

We don’t need a Royal Commission to report in four or five years’ time at a cost of millions. As you point out, we know what is wrong with the NHS. What we don’t have is a plan to fix it: a decision which is quite properly political, except that our politician­s are treating it as too much of a hot potato.

Changes in demand and in what medicine can do mean that the original model, however suitable for the Forties and Fifties, is not sustainabl­e. A free service that offers all kinds of healthcare to our whole population is unaffordab­le today. If politician­s can offer a meaningful vision for what we could achieve, then we might start working towards a realistic goal.

Tony Fry

Ruthin, Denbighshi­re

SIR – Philip Duly (Letters, February 11) advocates more private involvemen­t in the NHS. Over the past few years we have seen the privatisat­ion of the railways, buses, gas, electricit­y and water. This has not produced cheaper services, and many are now owned by foreign companies or investors.

I am a great believer in private enterprise – but only when it can produce a better or similar service at a cheaper price.

Howard Stevens

Stockton-on-Tees, Co Durham

SIR – The fact that surgeons are left kicking their heels in the NHS (report, February 13) is nothing new. I was a consultant surgeon in the mid-Eighties when I wrote to Margaret Thatcher to tell her that I was working in my garden on a Monday morning instead of doing my operating list, because there were no beds for patients.

The patients on whom I should have operated were then put back on the waiting list and had to be treated at a later date, thus making my operating list longer. In spite of those events, successive government­s have continued to close beds, meaning that the problem today is even worse.

Just over 10 years ago, a Labour minister told us in public that the only reason that we had waiting lists was because surgeons were on the golf course instead of working. This attitude to surgeons – who had spent many hours working at weekends and at night – was so demoralisi­ng that, shortly after, I took early retirement.

Michael Lavelle

Scaynes Hill, West Sussex

SIR – Some of the blame for the situation in the NHS should be placed on our local planning authoritie­s.

We have seen many new housing developmen­ts, and large increases in population, without the necessary increases in infrastruc­ture.

The result is overloaded GP surgeries. Had local authoritie­s made additional GP facilities a requiremen­t in the developmen­ts, we might have avoided this problem.

Andrew Spanner

Watford, Hertfordsh­ire

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