The radio alarm rouses me with the drone of John Humphrys giving some poor soul a good grilling about the Pfizer-riser, the new wonderdrug that everyone is talking about. The pre-release publicity and media coverage have been fantastic, and not a day goes by without mention of Viagra ('Upping the stakes', Managers & Medicine, pages 10-11, 27 August).

Of course, doctors are the worst offenders because they keep quibbling about all the time needed for extra consultations, counselling, follow- up and clinical audit, not to mention the financial implications for their already over-stretched drug budgets. Some doctors are even talking about rationing: one GP has already drawn up an age-related protocol setting targets for his patients to achieve. Every week the medical press reports that the NHS cannot satisfy the very basic needs of its clients.

Any form of control mechanism introduced by the government will also attract the premium of restricted availability. If Viagra is treated as a controlled drug, it will attain 'black market' status with a price to equal that status.

So why all the excitement? There have only been 69 deaths in the US, and none of these have been directly attributable to Viagra. Apparently, it is the unaccustomed over-exertion that has been the underlying causative factor. Do I hear cries of 'what a way to go'?

Perhaps the government should make Viagra widely available as an over- the-counter product.

Pharmacists are always screaming they do not have enough to do and that they are quite capable of treating minor ailments, so let them do the counselling. The more they sell, the bigger their profit margin.

A unique opportunity exists for an astute government to raise extra revenue through VAT on Viagra - sex tax. The extra revenue could be channelled into healthcare, and people would once again feel they were making a positive contribution to the economy.

Des Lawrence

GP

North Warwickshire