Letter: Expensive hospitals

Sir: I am at a loss to understand how Dr Michael Dixon (letter, 26 November) can make such an ex cathedra statement as that the NHS "is at least as efficient as any other European health system", unless his definition of efficient means that a smaller proportion of the GDP is spent on health.

Nor can I understand why he assumes that the alternative to the NHS theology is a greater involvement of the private sector.

In Belgium a patient going to a GP has a free choice of doctor and can exercise genuine consumer choice by going to another doctor next time. The GP, who will allow at least 20 minutes for a consultation, will then charge pounds 10 (610 BF). If the patient belongs to a defined group of handicapped, poor or seriously ill people his local mutuelle (a non-profit-making insurance organisation) will repay between 80 per cent and all of the cost.

The hospital system works in much the same way except that the mutuelle will normally arrange for the hospital bill to be sent directly to them and they will sort out which fraction, if any, will have to be paid for by the patient.

The whole system is based upon the willingness of Belgians to pay about 1 per cent more of the GDP to healthcare.

TONY CASTON

Tervuren, Belgium