Your article 'I hate the bastards' (news focus, 8 April) arouses remarkably strong feeling among my colleagues and myself in response to health select committee chair David Hinchliffe's comments about the independent sector.
I do not have to apologise for moving to work in the independent sector as medical director of a charitable hospital. After 22 years in the NHS with an average week of 70 to 80 hours, finally working as both a consultant psychiatrist and trust medical director and having been replaced by four consultants, I have done my share to repay my training costs.
I moved to the independent sector because the health service was failing to provide care for the people in whom I am most interested - people with serious mental illness and challenging behaviour. I now work for a group which can translate clinicians' dreams into reality, not out of greed but because of shorter lines of communication, ease of decision making and no perverse incentives.
It is the NHS's failure to provide facilities that has led to the expansion of the independent sector, particularly in mental health.
In medicine and surgery, it is surely naive to believe that we can regulate out the independent sector. I too would like to believe that we had a properly funded health service that was so good nobody would wish to use the independent sector. But what chance is there of that, when the government that Mr Hinchliffe supports refuses to increase taxation - surely the only way of substantially increasing funding to a very underfunded health service?
People are going to vote with their feet, and if they have the money will pay for private healthcare. Many of them are not rich. They are working people who choose to spend their money on operations, healthcare or psychiatric care rather than on alcohol, cigarettes or gambling.
A lot of training goes on in the independent sector: many large independent psychiatric hospitals have their own nurse training and occupational therapy schools, although these have now, for reasons of education policy, been merged with local colleges. We would like to do more, but are often precluded by colleges - or indeed, the royal colleges - from having more training placements.
Is health to be the only sector in this country where people cannot choose to sell their labour where they wish?
Should Mr Hinchliffe repay the costs of his social work training now he no longer works as a social worker but as an MP? Should those members of the health select committee who have other qualifications, including those in medicine, repay the costs of their training? Should all the lawyers in Parliament repay the costs of their training because they do not work in the public sector? This is surely nonsense.
Michael J Harris
St Andrew's Hospital