Minette Marrin calls Michael Moore’s film Sicko crude, manipulative and one-sided but her article last week was itself one-sided. We are fortunate to have universal and free health service cover, whereas President George W Bush has just vetoed the extension of the state children’s health insurance programme. This leaves 3.2m American children with no entitlement to healthcare unless their uninsured parents can scrape together or borrow to pay for medical treatment. Many criticisms can be levelled at the NHS but there is much about it that is praiseworthy. It is salutary to note that, despite the increased prosperity of the past two decades, the proportion of British adults who pay for private health insurance is 6%.

Marrin mentions the very serious problem of the recent outbreaks of C diff (clostridium difficile); hospital acquired infections are not unique to the NHS. C diff infections are a worldwide problem, with a new strain recognised as causing a pandemic. There is also evidence that in the United States 64% of staphylococcus aureus bacteria are methicillin resistant (MRSA), whereas the UK figure is currently 44%. Despite the high cost of privately-funded healthcare in America, 2m patients are said to suffer hospital acquired infections annually. Much needs to be done to improve the NHS for the 21st century, but it has far more positives than negatives.

Dr Margaret Daly, Consultant in Clinical Oncology
King’s Lynn, Norfolk

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