Letter: NHS ignorance

Sir: Winter approaches, health service budgets are overspent and the prospect of lengthening waiting lists looms. This is not due to a failure of the NHS and cannot be cured by recourse to the much more expensive private sector.

Waiting lists exist for a reason. They are the surest as well as the crudest and cruellest method of rationing public expenditure in health care. Pretending that they can be eliminated by management changes, reducing waste or increasing efficiency is fundamentally dishonest.

Waiting lists have been and remain an integral part of government policy for restricting spending in the health service. They will continue to be until a decision is made either to increase the NHS budget very significantly or to adopt alternative, more discriminating methods of rationing health care.

We are fortunate in having the most cost-effective system of health care in the world, but we cannot have a first-class service at a second-class price. The Government and opposition parties must give the electorate honest choices between putting a lot more money into the NHS, or creating explicit policies for restricting the range or availability of health care.

Dr NICK LEACH

Market Harborough, Leicestershire