Alan Johnson, the health secretary, is disingenuous when he says it would create a two-tier NHS if Jack Hose were to buy the drug cetuximab directly (Cancer victim told to pay for drugs , News, last week). There is a four-tier NHS in the UK, and created by this Labour government.

Hose is English and therefore is in the bottom tier in terms of available spending for such drugs. If he were in the top tier (Scotland), this drug would be freely available to him. This is the result of Scotland having its own parliament and Gordon Brown’s refusal to correct the long-discredited Barnett formula, which means Scotland receives more money than English regions.

I can understand why Brown continues to deny England a parliament and refuses to base UK spending on need. Johnson, on the other hand, represents an English constituency and is responsible for the English NHS, so what is his excuse?

Cliff Yates Grimsby, Lincolnshire

HEALTH PLAN

Perhaps Alan Johnson should look across the Channel to Germany for an example of how to learn “fairness”. There, if a contributor to a compulsory social medical insurance scheme opts for private treatment, the provider is obliged to contribute for the cost of standard treatment.

The patient pays the difference. This has led to a healthy market for “top-up” insurance – thus increasing the flow of money into healthcare for the benefit of all.

David Sansom Wells, Somerset

POPULATION PROBLEM

DOMINIC LAWSON’S review of Fatal Misconception (Books, May 18) summarises this book’s description of the paternalistic, even directive, nature of postwar population control campaigns.

Like the book, however, he draws the wrong conclusion. Since the 1960s the global population has doubled and is expected to grow by almost three billion in the next 50 years. We’re already suffering from climate change, biodiversity loss and fuel and food insecurity.

Concern over this growth has been expressed by the Royal United Services Institute, the head of the CIA and the Joint Operating Environment projection prepared for the Pentagon, as well as numerous UN bodies and the government’s chief scientific adviser. Hardly freaks.

Limitation of family size through family planning is a right denied to many in the developing world, and it is needed more than ever.

Simon Ross London E18

FAILING SCIENCE

WHETHER or not Professor Neil Turok’s decision to accept a prestigious research post in Canada justifies his description of Britain as “amateur” will no doubt arouse controversy, but many of the criticisms cannot be disputed (Top physicist to quit ‘amateur’ Britain , News, last week). The appointment of career politicians (and others) without scientific backgrounds as science ministers, the lack of funding for scientific developments, and the financial insecurity of university scientists are merely symptoms of this failure.

But to these must be added the failure of the political establishment to defend British scientific inventions of major industrial importance to the UK. Two outstanding examples in which I have personally been involved come to mind: the invention of monoclonal antibodies at the MRC molecular biology laboratory at Cambridge in 1975, and of so-called microarray (or “biochip”) technology at University College London in the late 1980s and early 1990s.

Both inventions are of key importance in the field of diagnostic medicine, the latter enabling the simultaneous detection and measurement of hundreds (or even thousands) of substances of crucial medical importance (such as hormones and DNA) with exquisite sensitivity in a drop or two of blood.

The first of these inventions was valued by the journal Nature at $5 billion (£2.5 billion) per annum; the second, by an American financial journal (Business Week), at $40 billion. Though the latter prediction is probably exaggerated, such sums are not chicken feed, even by comparison with the estimated cost of the Olympics in 2012.

Both are being aggressively exploited in the US (with support of the US courts, based on totally specious grounds) without benefit to the British economy or protest by the British political establishment.

Professor Roger Ekins University College London

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