I was deeply shocked to be described as 'right-wing' in your recent item about my book, A Better State of Health (News, page 8, 25 June). As a former general secretary of the Fabian Society, I feel stung by such a serious allegation.

Is it right-wing to want to preserve the NHS? I believe it is slowly being eroded as those who can afford to, switch to private insurance. They are doing it because the NHS falls far short of what we expect from a vital service in the last decade of the 20th century. (Some evidence on this point cited in my book is drawn from HSJ , which has encouraged the professions to take a self-critical look at the health service. ) If opting out continues to grow, the NHS may keep going, but it will become what its supporters have always struggled to avoid: a rump service for those too sick or too poor to buy private insurance.

Maintaining universal membership of the NHS means bringing more money into it. If taxpayers won't cough up, charges are the only alternative.

But the dilemma is this: the NHS must choose between its two key principles - universal in coverage and free at the point of use. If it stays free at the point of use, it will no longer be universal. To stay universal, it must cease to be free at the point of use.

Call that right-wing if it helps ghettoise the argument. But debate about how the NHS is to be funded is central to its future.

John Willman London SE14