“The old NHS was cheap — there were no transactions and all monies were spent on clinical care; now too much is spent on administration
Sir, May I remind everybody that in the days before the ludicrous “internal market” of John Major (1990), the NHS cost less than 7 per cent of GDP yet turned in morbidity and mortality figures that rivalled any health system in the world (“NHS faces £30bn shortfall and needs radical reform, say chiefs”, July 11).
Now it costs about 10 per cent of GDP per annum and has fallen radically behind in all measures. All of this money has gone on bureaucracy. The old NHS was cheap because there were no transactions and all monies were spent on clinical care. It is true that there were long waits but priorities were decided by clinical need which is surely how it should be.”
Dr Caroline Bonwitt Todenham, Glos
“Sir, Financial analysis of two failed hospital trusts came to the same conclusion in each — their problems were largely caused by an unaffordable PFI debt. Your report states that NHS debt is approaching £30bn. Two years ago the debt was estimated at £20bn so despite debt reduction measures over the last two years things are worse.
Extrapolating from the analyses at South London Healthcare Trust and Peterborough & Stamford, the majority of current debt nationwide is attributable to PFI. Widespread hospital closure is not possible as PFI hospitals are “locked in” for the duration of their contract — usually 25-35 years. Closures can only occur of non-PFI hospitals which by definition are financially more stable.
The failure of government to abandon, and/or buy out the PFIs, can only be explained by its wish to see the NHS fail, so that it may be replaced by private sector “efficiency”. The report on GP services in the South-West, which you printed adjacent to the debt crisis article, does not lead to any sense of confidence that involvement of private enterprise is either reasonable or safe.”
Dr Andrew Bamji Rye, E Sussex