People want a local hospital service which is readily accessible, adequately resourced and provides a high standard of care in all but the most specialised areas of medical work. Of necessity, these must be provided at regional or sub-regional level.

High standards of care require a seamless service between general practitioners and hospitals. GPs have a detailed knowledge of the skill and expertise of local consultants and to which one it is appropriate to refer a particular patient.

When local resources are adequate and working relationships are good, health professionals should be left to get on with their work instead of being distracted from clinical priorities by ever-changing government interference.

Mr Blair and Mr Howard may think that their particular ideas about choice in healthcare are vote winners. They are not.

Yours faithfully.
JOHN SEARLE,
Belle Isle Lodge, Exeter EX2 4RY.
johnlizex@aol.com
June 24.

From Dr Brian D. Keighley

Sir, Once again the NHS is set fair to become the filling in the Labour and Conservative policy sandwiches, and yet neither party recognises that the biggest problem besetting the service is the very political control each espouses.

Health has parallels with public broadcasting. Each is expensive, each pervades all sections of society and each is the target of aspirations for political control. The BBC, however, derives some protection from its charter and, while still at the centre of many political storms, is not vulnerable to ministerial whims generated by a single day’s critical press.

Health, like broadcasting, is too important to be the political football of major parties during the first skirmishes of an impending general election. The NHS needs a charter, it needs sensitive management, it needs to value and cherish its long-suffering staff and, above all, it needs to be isolated from the political process.

Yours faithfully,
BRIAN D. KEIGHLEY,
The Clinic, Buchanan Street,
Balfron, Stirlingshire G63 0TS.
bkeighley@aol.com
June 23.

From Mr Christoph Lees

Sir, Tony Blair’s vision for the NHS (report, June 23) is for much-improved healthcare arising from “personalised” public service reforms.

Now that we have seen several years of extra funding for the NHS, there has still been no significant improvement in patient choice. Nowhere exists the right (rather than the political promise) to expect a quality and rapidity of treatment that most of our European neighbours, rich and poor, unemployed and employed, old and young, universally enjoy through their own social health insurance schemes.

These schemes cost very little more proportionally than we currently spend in the UK. Importantly, they place the healthcare consumer at the centre of healthcare provision.

Why therefore is our reforming Government so averse to allowing us the most important reform of all: the ability to spend our healthcare pound in the way that we have every right to determine?

Your faithfully,
CHRISTOPH LEES
(Consultant in Obstetrics and Foetal Maternal Medicine),
3 Fair Street, Cambridge CB1 1HA.
June 23.

From Mr Thom Robinson

Sir, A quotation hangs on my GP’s wall:

We trained very hard, but it seemed that every time we were beginning to form into teams we would be reorganized. I was to learn later in life that we tend to meet any new situation by reorganizing; and a wonderful method it can be for creating the illusion of progress whilst producing confusion, inefficiency and demoralization (Petronius, AD66).

Yours faithfully,
THOM ROBINSON,
Basement Flat C,
1-3 The Common, W5 3TR.
June 24.

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