I am not sure that it is necessary for health secretary Alan Milburn to go to Spain to identify good practice, although not long ago I came across a hospital in Barcelona which had two MRI scanners that operated 24 hours a day, 364 days a year.

A short time in an acute ward here will often easily identify:

nelderly patients occupying beds because they cannot be found places in nursing homes or be supported at home;

nmany places that only work flat out in all departments Monday to Friday, 9am-5pm; ninefficient organising and timing of patients' clinical tests; nthe non-availability of specialist clinical staff.

Many patients are simply waiting in beds for things to happen before a diagnosis is made, treatment carried out or discharge arranged.

Getting a hospital to function in a different way requires resources to open x-ray and pathology fully at weekends, salary levels that reflect the private sector - an orthopaedic surgeon who can earn a six-figure sum elsewhere is not likely to be tied to their district general hospital - and probably larger hospitals, as having a consultant in situ for each specialty 24 hours a day needs big teams.

Jamie Sharpley Woking Surrey