Letter: Viagra rationed

Sir: The important point about the Viagra debate is that the politicians are, in effect, making clinical judgements. In the "rationing by queuing" situation, the judgements on who should get priority are made on medical need by medically qualified people who have an intimate knowledge of the patients concerned.

None of these conditions apply when a politician is making such a decision. Once the principle of political clinical judgement has been accepted, patients who may have been deemed to have "self-inflicted health problems", such as smokers and drinkers, could be the next to be excluded. No doubt after a well-orchestrated "spin doctoring" campaign with the co-operation of the abstemious media.

GRAHAM FISK

Birmingham