NHS at night

SIR – When my wife was seriously ill in hospital (Letters, November 15), I spent a lot of time at her bedside. I saw, and pointed out, that her condition deteriorated overnight, when she was less closely monitored, and more so during the weekend, when there were fewer decision-makers present.

I voiced my concern as we neared a four-day weekend at Easter. I watched as my wife’s health worsened during those days. Approaching midnight on the third day, Easter Sunday, she died. A single nurse was caring for nine patients that night, two of whom were in a critical condition.

Robert Marston

Newark, Nottinghamshire

SIR – I’m a retired consultant, and I know that so-called managers have multiplied dramatically over the past quarter of a century.

Hospitals used to be run by the consultants, who are the only people with the knowledge to appreciate what is necessary in healthcare. The medical executive committee consisted of one consultant from each specialty, and it discussed what was necessary for the proper functioning of the hospital. Its decisions were communicated to the hospital secretary, who implemented them.

Now, the hospital secretary has been replaced with a CEO, who is in charge of countless other managers. This grotesque experiment in managerialism has resulted in huge increases in expenditure without any improvement in patient care, as these managers are not medically qualified. They are appointed in order to prevent doctors spending too much money.

Unless this is reversed, with consultants put in charge of all medical decisions, the NHS will collapse. The health service exists to diagnose and treat. Doctors do this with the help of nurses, physiotherapists and others. They do not need managers, whatever politicians might imagine. Dr William T Easson Buxton, Derbyshire