Holy cow

Worse still, when they have held their monopoly positions for any length of time, their thinking is that they, themselves, are giving real value and service to the customer.

If there was only one greengrocer in Brighton and Hove, he could double or triple prices, open and close when he wished, take no notice of customer complaints and ignore the 200-yard queue outside in the rain.

He would be a monopoly. But the day another greengrocer opens opposite him with normal practices, he would have to change in ten minutes - which, mentally he would have a problem with - or go bankrupt. In other words, the customer would have choice.

The NHS is not the greengrocer but it is a long-term dyed-in-the-wool monopoly and, apart from the expensive private sector which does not have the full equipment or facilities of the NHS, the customer has nowhere else to go.

If the NHS costs £50 billion a year it is getting £862 a year from every one of the 58 million population or £66 a week from a family of four. This may be very good value but we have nothing to compare it with. Our hospital league tables must be a big step forward but the customer still has no choice but to get in the queue. This we moan about but accept because we do not have any other alternative.

As with the greengrocer, until we can see competing costs and service, we will never know the values. Politicians very simply cure their "complaints mountain" by putting in more money against increases in tax, so we pay more and still queue.

We see our NHS as a holy cow which must not be touched but allowed to plod on as it has done for 50-odd years without fundamental change. Every one of the Eastern bloc countries wiped out competition with state ownership and every one of them has gone bankrupt.

If it were possible to privatise 10 per cent of the NHS as an experiment, the results, whatever they were, would be interesting.

-V J Harman, Chalfont Drive, Hove