Letter: Needless surgery

Sir: Private medical insurance companies quite rightly wish to curb overactive surgeons following surveys which have suggested that up to 25 per cent of the 80,000 hysterectomies done in Britain each year may be unnecessary ("Bupa curb on knife-happy surgeons", 26 August ).

In the case of hysterectomy, there are now many alternative less invasive treatments for benign disease. There is also strong evidence that the value of other operations such as tonsillectomies and gall-bladder removal may be limited.

However, the private medical insurance industry may be shooting itself in the foot, because the main driving force for private healthcare is the existence of waiting lists in the NHS. It would be hard for consultants to deny that their private income benefits greatly from waiting lists and it may be in their interest to accumulate a waiting list in the NHS. A professor of anaesthetics once remarked that appointing a new surgeon never reduces waiting lists and that the amount of surgery performed expands to fill the time available in which to do it.

If 25 per cent of operations performed in the NHS could be shown to be likewise or unnecessary or if less invasive cost-effective treatments were substituted for the knife, then the reduction in such wasteful surgery could lead to the abolition of waiting lists in the NHS and the possible demise of the private healthcare industry.

VINCENT ARGENT F.R.C.O.G F.R.C.A.

Director

The Waiting List Company

Friston, East Sussex