I share Neil Pettinger's concern ('Richly deserving', 9 September) about poorer people spending longer on waiting lists and not getting equal access to elective services.

But his proposed solution, that the health service positively discriminates towards poorer people, could backfire by more people opting for private healthcare if they were not getting equal treatment with the NHS.

This would contribute towards a two-tier health service, where the NHS becomes the poor person's medicine. In the long term this might mean worse healthcare for the less well off, rather than an improvement.

The choice to stay with the NHS is an ideological one for me and many others. Positive discrimination might push people unwillingly to the private system.

Shouldn't we be striving for equal access for all?

Rhona McGurk Researcher Centre for research in primary and community care Hertfordshire University