Private practice

I expected that mentioning Enoch Powell's views about the NHS would generate a response. A correct prediction (Mark Boyle, Letters, 3 December)!

But it wasn't drivel to describe Powell’s three years and three months tenure as Health Minister as one of the longest; five of his seven pregiven decessors served on average 15 months. I also had in mind successors like Andrew Lansley (22 months), infamous for his disastrous “reforms”; John Moore (13 months) described by Edwina Currie as “useless”; John Reid (23 months) who said “Oh f*** not health” when appointed to succeed the PFI enthusiast Alan Milburn; Kenneth Clarke (28 months), well remembered for his utterance “Why is it every time that I mention the word reform, GPS reach nervously for their wallets?”; and Theresa Coffey (seven weeks).

It is wrong to say that I disingenuously attempted to paint Powell as an advocate for a two-tier NHS. When he was Minister of Health, healthcare outside the NHS was low volume. He predicted that substantial growth would only follow big increases in NHS charges or big reductions in NHS funding, and that in his view both were politically improbable.

But since his time everincreasinghealthcarecostsdue tomedicaladvancesandanageingpopulationaredrivingnhs deficits, leading to long waiting listswhichareencouragingthe growth of a two-tier healthcare system. It is not GPS who are reaching for their wallets, but patients who can afford private medicine.

HUGH PENNINGTON

Aberdeen