Letter: Citizens' NHS

Sir: Your leader (12 November) praises our European neighbours for providing faster access to health services than the NHS and concludes that the NHS must follow them by involving the private sector.

Evidence suggests, however, that the NHS is at least as efficient as any other European health system. Furthermore, we have "thought the unthinkable" with the introduction of Primary Care Groups and Primary Care Trusts. Professionals will now be more accountable to the needs and demands of the local population. Local ownership of the NHS could lead to patients viewing themselves less as consumers and more as NHS citizens with a more active role.

The result could be the sort of equitable, accountable and efficient health system that most of us should be prepared to pay for. However, will the wealthier be prepared to subsidise the poorer through a tax system that might, for instance, have a specified health tax?

If they are not, we will have to go for the private option. This is likely to be more expensive in the long run as shareholders will want to see return on their capital. Some would argue that we would also have reneged on the moral values that created the NHS in the first place.

Dr MICHAEL DIXON

Chair, NHS Alliance

Cullompton, Devon