Does the sticking-plaster NHS have a plan to prevent doctors leaving?

sir – As a full-time NHS doctor for 34 years – of which 29 were spent as a partner in general practice – I had high levels of both job and patient satisfaction, along with good remuneration. There was a stable workforce and locums were used infrequently.

My sons followed me into the medical profession. They qualified in 2010, and of their cohort many moved to Australia, New Zealand or Canada, some never practising in the country that trained them. Many others (of both sexes) now work part-time.

Some years ago, when Jeremy Hunt was health secretary, I spoke to him about low morale in the NHS and the exodus of home-grown talent. I put the responsibility at his door.

In November last year, the Nuffield Trust reported a 10 per cent cut in NHS doctors’ real-terms earnings since 2010. Meanwhile managers ensure that they protect their status, power base and remuneration, even though their effectiveness is questionable.

The doctors and nurses doing the hands-on work are undervalued and underpaid. Pension changes have exacerbated the situation for doctors. Rishi Sunak hurled money at the Covid crisis with complete recklessness, yet long-term investment in front-line staff has been ignored.

Until doctors are rewarded (in terms of their status and pay) at a level reflecting their responsibilities, the NHS will continue to decline.

Dr R Waddingham London SW18

sir – My GP referred me to a urologist following three hospital admissions within a year for the same complaint. Of the two hospitals available to me, the first had a waiting list of 66 weeks while the second had one of 54.

I therefore booked a private appointment in four days’ time. I am blessed to be able to fund myself, but this story is just one of many illustrating the need for drastic reform within the NHS.

The question, of course, is how to persuade people to come together to address this urgent issue. It will certainly require thinking outside the box.

Patricia Wood Kilsall, Shropshire

sir – Evan Llewellyn (Letters, January 20) is quite right that most people in Britain don’t know the real cost of medical treatment. Here in Holland, I can see my own personal costs on the website of my health insurer. During 2022, I paid around £2,400 in premiums and my insurer paid out almost £10,000 for my medicines, consultations and treatments. One three-night stay in a hospital for observation cost more than £5,000.

However, health insurance is not necessarily the answer for Britain. The situation will not change until NHS trusts and the apparently countless quangos understand and accept responsibility for sound financial management and budgetary accountability.

Alun Harvey Groningen, Netherlands