YOU report that doctors have been told to cast off their ties (News, last week) but when does the tie ever come into contact with the patient or their bed? Only gynaecologists are at risk of their ties and patients becoming accidentally entangled. Hence many sport bow ties; much safer during internal examinations.

Female doctors’ handbags, which not infrequently find their way onto the sheets of hospital beds, seem to be immune from contamination.

As a paediatric haematologist I would not be prepared to tell parents that their child had leukaemia or was going to die from a relapse while dressed as though I was going out to the pub for Sunday lunch.

The real causes of spread of infections within hospitals are inadequate cleaning services, failure to provide a stethoscope, otoscopes and ophthalmoscope for each hospital bed, and the need for someone to be employed to clean these essential diagnostic implements in between each patient. But, of course, that would cost money.

Dr Andrew Will
Altrincham, Cheshire

BACTERIAL CONDUITS: I am a consultant physician in rheumatology and have long-since abandoned wearing ties at work. None of my patients, NHS or private, have objected. Rather, they feel I am more approachable, less stuffy.

Patients are looking for a sympathetic and competent opinion, not a doctor whose professionalism is based on an anachronistic length of cloth, one which may serve as a vector for transmitting bacteria from one patient to another.

Dr Paul Reilly
Finchampstead, Berkshire

HEALTH HAZARD: As a retired surgeon who has operated in Britain and in Boston, Abu Dhabi, Baghdad, Khartoum, Riyadh, Jeddah etc, I believe I was the only surgeon in the world to strip completely before donning my operating suit and invariably taking a shower at the end of every operating list. My surgical colleagues wear their socks, underpants and sometimes even vests under their operating suits.

I think this observation may be more relevant to MRSA control than the wearing of ties.

James Boak
London SW10

CLEAN THE WARDS: Recently my husband and I discharged his mother from an NHS hospital after 18 days of what can only be described as solitary confinement. This however was not the worst point; she was admitted with, among other things, severe diarrhoea. We were stunned that, while we were expected to wash our hands with gel before entering the main ward and put on plastic aprons and gloves before entering her room, her soiled clothes were slung in a corner — and had been for a couple of days — and not on just one occasion.

Until cleanliness in the wards is addressed we should not worry about bow ties.

Veronica Carlton
Market Harborough
Leicestershire

GETTING IT IN THE NECK: As a non-tie wearing, non-antipodean doctor, I thought that any respect and trust which my patients had in me would be because I tried to treat them with respect and dignity and hoped to occasionally make a correct diagnosis and provide appropriate treatment.

Not according to Dr Michael Dixon, who says that my tie-less neck ruins any chance of respect and trust, whatever professional skills I may be able to demonstrate. Ah well, better put some ties back on the Christmas present list.

Tim Littlewood
Haematology Department
John Radcliffe Hospital, Oxford