Defending Labour’s proposal to contract with the private sector for NHS treatment, Polly Toynbee recalls the Blair government’s similar approach (Don’t panic when Stammer refers to NHS ‘reform’. He’s foiling a Tory move to destroy it, 16 January). A much more positive impression than some of us get from a detailed examination of the results at the time.

Yes, overall waiting lists were reduced, but at a significantly higher cost to the exchequer than equivalent elective provision within the NHS. The government was actually encouraging NHS doctors working part-time in the private sector to build up long waiting lists as they were generously rewarded for treating patients in their private practice.

The utter nonsense of so-called Independent Treatment Centers (ITCs) was brought home to me by a Wakefield constituent who spent nearly two years in agony waiting for a hip replacement on the NHS waiting list of a local orthopedic surgeon. He qualified for a referral to a new ITC based in a nearby private hospital and was surprised to find himself being treated there in private practice by the exact same doctor he had no time to see within the NHS.

Labor must recognize that using the private sector for NHS patients actually directly undermines the service, as a large number of private medical providers rely on doctors working in the NHS. One long-term answer to tackling waiting lists is to ensure that, while clinical staff are initially trained at substantial public expense, they are contractually committed to subsequent full-time NHS work. The party should think about it.
David Hinchliffe
Former Wakefield MP; former chairGeneral Health Committee

There is already “the means of making some modest contribution to the treatment of well-off patients” (Ken Clarke’s words, quoted by Polly Toynbee). This is called graduated income tax. I think what Ken Clarke really wants is a medium for good people no Overpaying for other people’s treatment.
Jean Warren
Garsington, Oxfordshire

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Keir Starmer’s prescription for the NHS is both empty and dangerous (Keir Starmer vows to tackle ‘bureaucratic nonsense’ to save NHS, 15 January). A major “reform” requiring significant long-term investment is to reverse the systematic decline initiated by Tory austerity measures. According to this Health Foundation Thinktank, UK spent £40bn less each year than comparable European countries in pre-Covid decade; Figures show that health spending per capita has fallen by around 18% in the UK.

Instead of criticizing GPs and suggesting that patients can go straight to a specialist or diagnose their internal bleeding at home, Labor must first commit to adequate long-term investment. Promoting primary care and public health, and addressing the social determinants of health, will enrich lives, improve the economy and pay for itself in time.
Dr. John Pontis
Co-ChairmanKeep our NHS public

To tackle waste and bureaucracy in the NHS, we need to end privatization and outsourcing. Over the last 12 years, since the passing of Andrew Lansley’s Health and Social Care Act, the NHS has undergone significant privatisation. Independent sector spending by NHS trusts An increase of 659% Between 2012 and 2021. Privatization creates waste. Research by the Center for Health and Public Interest shows that we do waste £4.5 billion In managing the internal market created by NHS privatisation. Meanwhile, a recent Oxford University study linked 557 preventable deaths to the outsourcing of NHS services. It is clear that we need to restore the NHS as a fully public service.
Johnbosco Nwogbo
Lead campaigners, we own it

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