Sir, Professor Calum Paton (letter, August 23) seems to suggest that alternative ways to finance healthcare will not increase the productivity of the NHS. I disagree.

On the latest figures, for example, France’s insurance-based health system costs a quarter more than the NHS but for that enjoys 60 per cent more doctors and 90 per cent more hospital beds.

Professor Paton says that the contributions of free-market think-tanks to NHS policy “begin and end with ideology”. In fact our proposals draw on common practice in other countries that do not have ideological barriers to possible reform. In Germany, 50 per cent of hospitals are run outside the public sector. In this country, the application of this thinking has hugely benefited patients.

Professor Paton says that invoking Reform “on NHS policy is like summoning Dracula to run its bloodbanks”. If anything we are trying to give the service a much-needed transfusion of new ideas.

ANDREW HALDENBY
Westminster, London
info@reform.co.uk

From Dr Andrew Bamji

Sir, I dislike Professor Paton’s assertion that it is wrong for senior medical figures to contribute to “moral panic about NHS finance”. Just because we have a “least bad” system should not prevent us from complaining when there are inequalities or waste.

While writing the history of my hospital I discovered an annual report, which stated:

The year under review was again difficult, owing to the ceiling placed on expenditure . . . and it was apparent from the outset that it would not be possible to provide adequate services within the sum allotted.

The year was 1952; my realisation of plus ça change has not discouraged me from protesting at underfunding, not least because, in a constrained system, funding Paul robs Peter. In my specialties (rheumatology and rehabilitation) I am usually Peter.

ANDREW BAMJI
(President-elect, British Society for Rheumatology)
Sidcup, Kent

From Mrs Thelma Hewitt

Sir, The NHS was set up to bring a satisfactory standard of healthcare to the nation. The size and complexity of medical advances — and the assumption that everything can be paid for through national insurance — has put the NHS under enormous pressure as it tries to satisfy all comers. At some point the Government must move away from the “free at point of entry” belief.

THELMA HEWITT
Stamford, Lincolnshire

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