There are good clinical reasons for concentrating specialist medical care in centres of excellence. My problem is that I no longer trust those who make and justify those decisions.

Moreover, I can’t help suspecting that the suggestion to move the children’s ward from Dorchester is designed to create a furore and leave us with a satisfying sense of victory when it doesn’t happen, while other controversial decisions go ahead unchallenged.

The Goebbels principle (if you repeat a lie often enough, it becomes the truth) is being well demonstrated in the repeated claim that we cannot afford the NHS. This country spends a significantly lower proportion of national income on health than most comparable countries. The US, for instance, spends roughly double for health provision that is more expensive for those who can afford it, and very much less effective for those who can’t.

Repeated international studies, often neglected by the popular media, frequently highlight the NHS as one of the most cost-effective systems available. We don’t always give as much credit as we should to things that we do well (which doesn’t mean that they can’t be even better).

We could, as a country, if we chose, afford to spend a lot more on health than we do. We cannot have US levels of taxation and expect Scandinavian levels of social and medical care. We need an adult debate, which we rarely have. In international terms we are moderately taxed, and those who can afford most are allowed, even encouraged, to evade their moral responsibilities.

If we choose not to afford proper, national healthcare, that is an ethical decision, made through our political processes, which will inevitably lead to avoidable deaths, principally among the poor, in large numbers.

Yours sincerely

Barry Tempest

Romulus Close,