Letter: Efficiency versus Christianity in the new-look health service

Sir: As a hardworking NHS consultant, I am appalled by the statements of Dr Sandy Macara, chairman of the British Medical Association ('NHS reforms blamed for 'doctors' despair' ', 5 July). The comments bear no relation to the health service that I see and work in, or to my experience of hospital managers. Indeed, they are an insult to many hard-working and dedicated hospital managers.

The dramatic changes that the NHS has gone through inevitably create uncertainty and upheaval, but there are many positive aspects of the changes and, far from increasing bureaucracy, we now have a system that empowers clinical services and boards whichrun hospitals to take decisions where they belong, at grassroots level.

Dr Macara's verbal assault could reasonably be described as scaremongering. I doubt it represents the views of even a minority of doctors. Likewise, the Bishop of Birmingham's comments are grossly ill-informed - surely it is far more 'unchristian' to operate a system that demonstrably wastes resources.

It is about time the BMA and the bishop participated in discussions on the best use of scarce resources with local health authorities and helped them to set priorities rather than score cheap political points.

There has always been rationing of health care. We have moved from a system where the decision-making was largely covert to a system where rationing in health care is becoming increasingly overt, as it should. Society has to take decisions on what services it can afford and what resources it wishes to provide. The hospitals and the professionals within the NHS have the obligation to use those resources as efficiently as possible, but they should be left to get on and run those services.

We have still one of the best and most cost-effective health services in the world, despite what the bishop and Dr Macara say.

Yours faithfully,

ANDREW J. MOLYNEUX

Consultant Radiologist

Radcliffe Infirmary

Oxford

5 July