Yet another article on waiting lists ('Richly deserving', 9 September). Neil Pettinger quite rightly points out that richer people spend less time on NHS waiting lists, have better access to elective treatment and can afford private healthcare. Why does New Labour tolerate waiting lists? In health matters, above all else, access to treatment should not depend on financial status. Prime minister Tony Blair has given a pledge on fast hospital bookings and underlined his determination to put patients rather than professionals at the heart of the NHS.

It is clear that hospital consultants could easily abolish waiting lists within existing resources but would have to accept managed care using cost-effective methods adhering to national guidelines and the National Institute for Clinical Excellence's recommendations. Correctly implementing the waiting- list action team handbook, Getting Patients Treated, could abolish waiting lists before the next general election. John Yates of Birmingham University has shown that hospital consultants control waiting lists and have the power to remove them.

I have been a consultant in obstetrics and gynaecology for 13 years and have seen how the abolition of waiting lists may not be a consultant's highest priority - I will leave readers to work out why. Following surveys which suggest that up to 25 per cent of the 80,000 hysterectomies done in Britain each year may be unnecessary, one private medical insurer now proposes that gynaecologists must seek prior authorisation before surgery. If 25 per cent of these operations in the NHS are really not needed, who will be the brave manager or clinical director who seeks to impose authorisation before the knife?

If alternative, less invasive treatments were used, gynaecological waiting lists would shortly disappear. The private medical insurance industry relies largely on the fear of waiting, and my colleagues may not be entirely happy if private healthcare collapses because of improved access to treatment in the NHS.

We consultants hold the key to reducing waiting lists. Who will grasp the nettle?

Vincent Argent

Consultant obstetrician and gynaecologist

East Sussex