SIR: I have some sympathy with Simon Lever. His letter (Chronicle, May 6)regarding missed appointments deserves consideration, although I do not agree with implementing fines. How would these be issued? Who would communicate? How would they be collected? It would be a bureaucratic nightmare. Constant repetition of the message about the cost is important which will help reduce the number of no shows.

However, there is a greater issue that I think he and everybody should be seriously concerned about, the future of the NHS which is being systematically and stealthily privatised right under our noses. The implementation of Integrated Care Organisations/Systems as confirmed in the Queen’s Speech on 11.05.2021 is a direct import into this country from US Medicare providers and global insurance corporations such as the Centene, Optum and Cerner Corporations. Centene have recently purchased 70 GP practices in the UK. NHS England is actively pursuing these commercial organisations ready to make sweeping changes to our free at the point of delivery health care to one to private purchase. The NHS we know and depend upon was described by American commentator and journalist Walter Cronkite as ‘exceptionalism.’ He also described the US healthcare system as ‘Not health, not care and not a system.’ 44m adult Americans have no health insurance & 38m have inadequate cover.

In 2015 STPs – Sustainability and Transformation Plans were introduced by the NHS. Their footprints do not relate to geographical, constituency or existing cultural boundaries. It is these that were to become Integrated Care Systems by April 2021. The government has had ample opportunity through the pandemic to utilise prompt commercial relationships, awarding in excess of £11bn in contracts without a shred of public scrutiny up to July 2020. In order to establish an ICS, hospital Trusts will be required not to be in deficit by 2023/24, a very tall order.

I would suggest that Simon’s concern about missed appointments is considerably overshadowed by a deliberately secretive privatisation of the NHS. We must ensure this does not happen.

Peter Rees

Member, Winchester Constituency Labour Party,

Monarch Way,