Sir, In June 2005 the National Audit Office expressed concern that more than 100 NHS trusts and authorities were in deficit, despite substantial increase in funding. We now know that this was only the tip of the iceberg. A proper diagnosis was needed to establish what had gone wrong and strategic teamwork to put it right.

The Government minimised the problem; either from wishful thinking or out of culpable ignorance of the real situation. Managers were blamed, but had a whole raft of managers suddenly become incompetent? Or was there a real problem?

No clear diagnosis has been offered. Part of the prescribed remedy is reminiscent of bleeding and purgation, standard medical treatment long ago. NHS trusts are now required to divert up to 15 per cent of NHS resources to the private sector, on the unproved assumption that the private sector is more efficient. What surer way of breaking the NHS camel’s back.

The full effect of this directive has yet to be experienced, but it will both seriously undermine financial recovery and compromise the critical mass of staff needed to underpin emergency services. Of course, it is not difficult to balance healthcare books if you do not provide a comprehensive 24-hour service, exclude the elderly from long-term care, do not fund highly expensive cancer drugs and do not provide education and training for doctors and nurses.

I therefore welcome the proposed parliamentary investigation into the NHS, but please involve doctors with their feet in the muddy NHS trenches, of whom there are likely to be vanishingly few in Parliament. Let us have a full, frank, multi-factorial diagnosis on which effective treatment can save our NHS.

PROFESSOR PETER RICHARDS
President
Hughes Hall, Cambridge

Explore Letters

• Feedback