Professor Le Grand's assertion in your piece 'Just a Pawn in the Game' that despite being badly served under politicians, the NHS 'would have been worse under any other way of doing it' does not stand up to international scrutiny.

There are many other European health systems as committed to universal healthcare as the UK - that, according to the Organisation for Economic Co-operation and Development, achieve roughly equivalent scores on equity - yet produce patient satisfaction levels and health outcomes far above those which the NHS manages.

I do not believe this has anything to do with standards in the medical profession. Instead, they have engineered health systems that are much more decentralised, competitive, free from state control and subsequently able to genuinely serve the patient rather than the government.

It would be well worth giving serious attention to such options.

James Gubb, director, health unit, Civitas