Congratulations to Allyson Pollock for her relentless campaign against the destruction of the NHS by the government (The toxic world of globalised healthcare, 28 August). Many people do not realise what an extraordinary service it was. Not only did it offer unlimited care to everyone without charging more to those who used it most, which no private organisation could ever do, but its consultants offered patients genuinely impartial advice on what treatment would be best, rather than recommending the treatment which would make them the most money.
Patients are the most vulnerable consumers in the world, given that they cannot possibly evaluate what treatment they really need for themselves in such fast-moving and highly technical fields such as medicine and surgery. By the same token they are ripe for exploitation by commercial companies, which is why healthcare costs as a proportion of GDP are so much higher in the US than here, despite the fact that only very basic treatment is available over there to those who cannot pay.
It would be far better for us to keep the NHS and restrict the range of treatments available, using recommendations by Nice as a basis for national decision-making rather than to marketise the service and tell patients that they must pay for anything the NHS "cannot afford", which is obviously the thin end of a wedge. Live-now-pay-later schemes such as PFI merely transfer costs, plus profits for the firms involved, to future generations and are similarly a national disgrace.
Dr Richard Turner
Harrogate, North Yorkshire
• Geographical disparity in medicines and treatments will only get worse now the Andrew Lansley health bill has become law. Your report ('Scorecards' to end inequality over NHS drugs, 28 August) describes how currently it is up to primary care trusts across the country to decide when to permit access to new and/or expensive drugs. Once clinical commissioning groups (CCGs) take over completely next April, it will be up to them to make these decisions. CCGs are "local doctor"-led and it is they who will control usage and expenditure (both in their own prescribing in primary care and in their commissioning of treatment by hospitals).
There is thus an inherent conflict of interest (making clinical decisions while at the same time controlling treatment budgets) operating in the new arrangements. At least PCTs had some neutrality in their decision-making. The only way to tackle the problem of variations in CCG expenditure on new medicines now will be for the centre to intervene – hence the "scorecards" that the Department of Health says it intends to introduce. The centre rules yet again despite Lansley's avowed intention to devolve power to doctors at the frontline. Some of us predicted this months ago.
Gillian Dalley
London
• It is good that the new chair of the BMA is opposed to Lansley's so-called reforms of the NHS in England (Report, 1 September), but the time is soon coming when BMA members must put their money where their mouths are. Through their role in the new CCGs, doctors have a unique opportunity to shape the NHS and keep it public.
There are some simple guidelines for them to follow. Do not accept into CCG membership any doctor who has a direct interest in a private health firm or out-of-hours service. Do not use any private firm or consultancy in running the CCG. Do not contract for the provision of services with any private medical firm or social enterprise. Most important, automatically bin any advice or guidance from the Department of Health and its satellite bodies, and do the right thing for the NHS and its patients in your area.
Robin Wendt
Chester
• It is ironic that on the same day you report on difficulties with NHS commissioning board appointments (Report, 29 August), you publish adverts for four highly paid directors on the board who will "stimulate a vibrant market to unleash the power of data" and "lead on the NHS brand so that the NHS has a clear and strong offer to patients".
Perhaps potential candidates have sensibly decided they do not want to be part of an organisation that puts out such meaningless claptrap!
Ian Arnott
Peterborough