‘Free’ NHS

sir – It is unclear if Dr William Walker (Letters, October 4) is criticising the Canadian healthcare system for expecting payment for service. Had he been at a private hospital in Britain, he would have faced the same situation.

In the past, when we trusted people, I had several foreign visitors who failed to pay for treatment. One gave a false name and address; another had a taxi outside the hospital, into which his wife pitched him from a wheelchair, and was at the airport before we knew he had gone; others assumed their home healthcare insurance covered them in Britain, which it didn’t.

Interestingly, they were all American. We learnt to take at least a credit card payment before admission.

To people in our country, however, the NHS has given the false impression that healthcare is not only free at the point of delivery, but free.

David Nunn FRCS

West Malling, Kent

sir – Sally Bennett (Letters, October 1) mentions suffering from “scanxiety” when awaiting the results of radiology investigations. She is not the only one affected. Radiologists also suffer, but for totally different reasons.

We are highly trained doctors who interpret all of these scans but we work in a specialty with 1,900 vacancies, predicted by the Royal College of Radiologists to rise to 3,600 by 2025. We are over capacity, with more scans being performed than we can look at, so there is the inevitable delay in getting the scans reported.

We are acutely aware that patients are coming to clinic to get results, and if we know they are coming we can direct our attention to their scans so that they don’t have a wasted journey. This doesn’t always work and, by doing it, we are moving other more routine work further down the reporting list.

Each scan is complex and consists of many hundreds, sometimes thousands, of images that all need to be manipulated and looked at carefully. We don’t want to rush because each patient deserves their scan to be reported as accurately as possible in order to inform the next part of treatment or provide reassurance that all is well. Some scans are quick to look at, others take a long time to consider, and we give each one the time it needs.

The main problem we have is that we don’t know what is on a scan until we look at it, and so our anxiety is not only fuelled by the long list of unreported examinations, but also by knowing that all sorts of serious and potentially life-threatening pathology might be present on a scan as yet unexamined. This is particularly the case with routine scans.

There is no easy answer for either patients or radiologists, and until someone has the nerve to make some difficult choices, this situation will sadly continue.

Dr Heather Harris

Sheffield, South Yorkshire