Letter: Efficiency versus Christianity in the new-look health service

Sir: The Rt Rev Mark Santer is absolutely correct ('Bishop condemns Tory health reforms', 4 July). For the past few years, the Government has been trying to inject a change of ethic into health care. I and my colleagues trained in a healthcare service whose highest and only justification was the best interests of the patient. Now we are being told to act in the best financial interest of the trust.

Many hospitals are prioritising patient care not according to clinical need, but according to where the money comes from. If we 'over perform' (ie, treat more patients than we contract for), we incur costs that are not met. Thus, we are instructed to take fewer patients from practice A (we have done their contract) and do more from practice B (a fund-holding practice).

If the politicians are successful in transforming the health service into an entrepreneurial business, the workers in that business may well consider their own worth and demand equivalent remuneration. The vast amount of effort put into health care by doctors, nurses, paramedical staff and ancillary workers will cease to be provided on a goodwill basis as it is now, and a strictly 'fee for item' ethic will evolve that will spell the death of the health service. This will degrade the quality and quantity of health care to those who cannot pay for it themselves.

Many of us in the healthcare service take great offence at the pronouncements of Tom Sackville (junior health minister) and his colleagues, most especially when they tell us that all is well. We can see clearly that all is not well, and we fear for the care of our patients.

Yours sincerely,

E. P. McKIERNAN

Consultant Anaesthetist

Preston

5 July