Patients need to wean themselves off the illusion that the NHS is free

sir – Dame Esther Rantzen (Letters, May 10) is not alone in admiring the NHS for its wonderful work – but a “free” service it most certainly is not.

We would do well to remember that the NHS costs taxpayers a very great deal of money. Patients should be treated like customers who have paid dearly for their treatment, rather than the recipients of generous charity from the Government. Denis Kearney

Lostwithiel, Cornwall

sir – Like Lynne R Wells (Letters, May 4), I had to wait a long time for a telephone consultation with an NHS physiotherapist about a longstanding back problem.

We spoke for 40 minutes, and he decided that I suffered from a “boom and bust” cycle, which could be broken by reducing my daily workload. Instead of washing my car in one go, I was to clean the wheels one day, the bonnet the next, and so on.

After washing two wheels, however, my back gave in. So now my back still hurts and my car – except for those wheels – is still dirty. Where to now? Brian Williams

Malvern, Worcestershire

sir – It is clearly the case that the NHS is overly bureaucratic, inefficiently managed and failing in many respects.

If a single root cause is to be identified, it must be the Griffiths report of 1983, which recommended the introduction of general management. This was inappropriate for a public service monopoly not subject to the disciplines of a competitive market.

Until then, clinical leadership, although not without its flaws, held sway at most levels of decisionmaking. It was naive to believe that this could be sidelined – as it certainly was – and executive responsibility placed solely in the hands of business executives and boards.

The notion that experienced medical and nursing professionals could not be trusted with leadership roles was misguided, and likely to have

sir – For an exemplary medical service, J S B Schollar (Letters, May 10) need only look to France. I can vouch for this, having lived there for 18 years.

Individuals receive most blood test results within 24 hours thanks to a country-wide network of analysis laboratories. These can be taken immediately to a GP.

In my own experience, often time-sensitive X-ray and scan reports were available straight after the appointment, and the radiologist provided a one-to-one debrief. Where I had complications, I was referred to a “cabinet” of consultants, of whom I could choose one to deal with me through a state-run polyclinic, rather than a huge, impersonal hospital.

Compared with this system, the NHS is an over-politicised mess. Philip Congdon

Poyntington, Dorset