A health system that gives power to the patient

SIR – I was an NHS consultant for 31 years and also did private practice. I have worked in two hospitals in America, clinics in Canada, Germany and Kuwait, and visited hospitals in Denmark, Sweden, Finland, South Africa and India. I have been an in-patient in France (medically first-class).

All top-down funded organisations become bureaucratic and wasteful. I recently came upon a book called The Cure That Works by Sean Flynn, an American academic economist. He describes the Singapore health system in some detail. It gives power to the patient, because he has his own pot of money to spend on himself. This eliminates the waste of third-party payments and encourages sensible behaviour on the part of the public.

An enlightened governor of Indiana has introduced the same system there.

Ian Strachan

Blairgowrie, Perthshire

SIR – Introducing a set charge to visit a GP (Comment, January 12) would indeed discourage time-wasters and missed appointments.

However, the small charges originally set for dental treatment, opticians and prescriptions very soon escalated alarmingly from the original sum. This might well happen again. It is not the answer, alas.

Shirley Puckett

Tenterden, Kent