Letter: Speedier treatment on the NHS

Sir: As a partner in a non-fundholding general practice, I can reveal definite evidence of the existence of a 'two-tier' level of service being provided by our local district general hospital - but (for the moment anyway) in the opposite direction to that which is usually assumed.

I recently referred a woman to a local general surgeon for varicose vein surgery as a National Health Service patient. I was rather surprised when she was called in for her operation within weeks rather than months. When she queried the speed with which she had reached the top of the waiting list, she was informed that she had received such speedy service because all of the local fundholding practices had reached the end of their year's budgets, and had asked the hospital to stop operating on their patients until the end of the financial year.

The hospital, ever keen to keep the money rolling in, had therefore decided to fill operating theatre time by sending for patients from non-fundholding practices (for which the district health authority will pay). Oh what a tangled web we weave . . .

Yours sincerely,

STUART BULL

Boston, Lincolnshire

25 March