We had high hopes for the NHS when Labour took office, but although it may be improving, the evidence is not obvious on the ground. Millions of citizens are still suffering, and we bump into them all the time.

It took a long time for the penny to drop in the NHS that soaring waiting lists and times, and patients on trolleys in corridors were due to the costly centralisations of the last administration, which lost too many beds. What were supposed to be super acute hospitals were being smothered by recuperating patients whom they were unable to discharge.

Of course, local councils are responsible for patients discharged into the community, and patients were being caught up in the wrangles between the NHS and councils.

The issues are not resolved. Costly and extraordinary measures have been taken to reduce waiting lists, but they will return to crisis level when ordinary conditions prevail.

Health secretary Frank Dobson says his general approach is to encourage rather than criticise NHS authorities (news focus, 1 April), an attitude which will not be very helpful here. We have predicted these problems since the Tory legislation and reorganisation, and have made constructive criticism which the authorities are too proud to recognise. It is all very well for the government to have good intentions, but positive results, evident on the ground, are needed.

They will not come unless mistakes are recognised and remedied. We are told by health authorities that a lot more cash is becoming available, but is it being wasted on stop-gap measures and cosmetic improvements? The NHS will continue to go from crisis to crisis unless this scenario is recognised. As well as introducing more bureaucracy into the service, primary care groups could introduce more problems than they solve.

The present HAs should be allowed to develop and evolve rather than waste resources and revenue on PCG experiments.

A serious re-think at the highest level is needed to get the NHS on to a proper footing. And it must be done urgently if it is to cope with the national need.

Eric Naylor

Co-ordinator

NHS Patients Campaign

Essex