I was surprised to learn that more than 90 per cent of users were apparently satisfied with NHS Direct. Possibly, as in other satisfaction surveys, users are being asked the wrong questions.

Although I work in Scotland, which hasn't as yet had access to this type of service (despite the fact that Alexander Graham Bell was born here), my mum still lives in England. She has been quite ill recently and there is always a long wait for accident and emergency or out-of-hours GP care. So I encouraged her to seek help, especially during the night, via NHS Direct.

Although she is physically frail my mum is mentally extremely alert and articulate, but all her attempts to squeeze advice from NHS Direct resulted in her being told to contact her GP.

The full extent of her frustration was brought home to me when I was caring for her a couple of weeks ago. Again, in the middle of the night and to avoid a wait of several hours, I phoned NHS Direct with a query about my mum's medication, as she was literally rolling around the floor howling with pain.

The nurse told me that the best advice she could give me was to tell my mum 'to pay and go private'.

I realise this is hardly a scientific study, but that conclusion was bizarre in the extreme.

I wouldn't have believed it if I hadn't heard it with my own ears.

Dr Pat Straw Quality manager Lothian University Hospitals trust Edinburgh