Britain must learn from health systems abroad if the NHS is to survive

sir – I began work in the NHS as a medical student in 1959 and retired as a consultant in 2005. The Beveridge Report of 1942, which resulted in the NHS in 1948, was appropriate for its time. But times have changed and we have a situation neither Aneurin Bevan nor Beveridge could have imagined.

The quotation, often attributed to John Maynard Keynes, “When the facts change, I change my mind – what do you do, sir?” could not be more appropriate. Look at the evidence. The health services in Ireland and Europe, Australia and New Zealand, take up about the same proportion of GDP as here yet death rates are lower, cancer survival rates are better, patients are seen instantly by GPS or consultants and waiting lists are non-existent.

It’s not down to the quality or dedication of our doctors and nurses, who work to the best of their abilities. It’s the fault of the system. If other countries’ systems are better, why don’t we change and copy them? Richard G Faber FRCS

Shefford Woodlands, Berkshire sir – I saw my GP yesterday with a list of symptoms warranting an urgent two-week referral. I am considered high risk for a type of cancer. She did the referral but told me that the waiting time for an urgent two-week referral is currently 10 weeks. This is simply unacceptable and I feel helpless and worried.

Beryl Sanders

Fulwood, Lancashire

sir – I completely agree with Simon Harper’s analysis of the decline and fall of UK general practice (Letters, January 9). However, it is unfair to attribute all the blame to the Conservatives, as the 2003 contract, which introduced the bulk of the targets and incentives that Dr Harper mentions, was negotiated with the then Labour government. Regrettably, GPS voted to accept it.

The rot started in 1991 under the Conservatives, with the introduction of the purchaser-provider split and GP Fundholding, and Dr Harper is quite correct to state that successive governments failed to recognise the value of general practice.

Before I retired in 2011, the words from Joni Mitchell’s song Big Yellow Taxi often came to mind: “You don’t know what you’ve got till it’s gone.” Unfortunately, now it has gone.

Dr David Shoesmith

Acklington, Northumberland

sir – The Health Secretary has said that he wants to make more use of community pharmacies (report, January 10). My local pharmacy is closed at weekends and now has to close at other times if there is no pharmacist.

Ann Wright

Cambridge

sir – Isn’t it time that GP practices and hospitals were paid per consultation or procedure, as they are in the private sector, instead of being paid regardless? The best would then expand, the worst would be taken over. John Adcock