Sir, Your correspondents (letters, Dec 6 and 7) grappled with the problem of lack of money for the NHS.

We, the people of Britain, want a national health service but want to contribute as little to that service as we possibly can (because we don’t like paying taxes). Yet most of us don’t seem to take care of our own health to minimise the cost of this service to the taxpayer.

If we are unhappy about NHS funding but don’t want to pay more taxes, why don’t we look after ourselves better? Applying suntan lotion on holiday, eating better, giving up smoking and taking more exercise would make a huge difference.

JAMES GOLDMAN
London NW4

Sir, L. C. B. Long (letter, Dec 7) links the cutting of operational costs with loss of frontline carers. Not so. There are many areas where costs can be cut and frontline services improved.

I hope to offer a light at the end of the tunnel. My letter on NHS business efficiency was published in The Times (Oct 5) and I was subsequently invited to share my ideas for improvement at a senior level in the Department of Health. In a pilot project at our local primary care trust, I now plan to show that we can cut costs by at least 10 per cent and demonstrate a clear, measurable improvement in clinical care for the community we serve. This is in a trust that already performs well.

With due respect to the accounting profession, it is not these skills that are needed to help the failing trusts. The solution lies in understanding good organisational design, dismantling bureaucracy and an unwavering focus on the elimination of waste.

KEITH W. BANKS
Thorpe-le-Soken, Essex

Sir, Despite the thousands of extra clinical staff recruited since 2000, management costs in the NHS still total less than 2.9 per cent of overall expenditure.

DIANNE M. JEFFREY
Chairman,
High Peak and Dales Primary Care Trust

Sir, There are obvious paths to improvement in the health service, should we choose to take them. There are, throughout the world, many fine, efficient and effective health services from which we could learn. Let us drop our prejudices and look abroad to learn from others.

My choice to live in the US was in large part due to the excellent healthcare I receive — at a cost, when expressed as a part of my salary, no greater than I would pay for the dismal NHS.

JOHN A. BLACKLEY
Austin, Texas

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