YOUR report of the waiting times for ambulances to deliver patients to the A&E Dept. (SA 6th Feb 6) is but a symptom of a general ‘sickness’ throughout the NHS.
The whole NHS is suffering from chronic ‘starvation’ and ‘exhaustion’ from overwork (as are the social care services). 
Attempts at ‘palliative’ treatment by the application of ‘sticky plasters’, over the years, by politicians, has proved ineffective. 
It now needs ‘radical surgery’ if it is to be brought back from ‘death’s door’.
The basic ‘diagnosis’ is that demand exceeds supply. This has been so ever since its inception in 1948; but it has got worse in recent years due to an ageing population that get more diseases that can now be treated by very effective, but expensive, treatments (such as coronary artery stents or by-passes, chemotherapy for cancers, and joint replacements for arthritis).
The ‘solution’ is simple but unpleasant and painful – increase supply or reduce demand; or a mixture of both.
Increasing supply means more money (increased taxes) and staff for front-line services.
 Reducing demand means some sort of ‘rationing’ of the services available on the NHS and/or charges for some treatments. Both of these ‘treatments’ are too painful for politicians to contemplate.
There is, already, a shortage of doctors and nurses; and there is difficulty in recruiting and retaining them – due to the conditions they have to endure. It takes several years to train such professional staff; so politicians’ promises to provide more doctors and nurses will take time.
The idea of making charges for some types of care undermines one of the mantras of the NHS – “free at the point of delivery” but this principle was abandoned in 1952 with the introduction of prescription charges (and charges for spectacles and dentistry). 
The basic principle on which the NHS was founded was that “no one should be denied essential treatment due to their inability to pay for it.” 
Few other countries have a totally ‘free at the time of treatment’ service; and it is open to debate as to whether some conditions are diseases that need treatment.
Politically, the NHS is a hot potato. There is too much political dogma that would have to be abandoned to reach a reasoned solution; and it would be political suicide for any politician to mention any of my proposals – for they would lose votes!
This is why it is essential that we have an independent review of the NHS by a committee (or commission) that represents all interested parties.
Thus, it must contain representatives of all political parties, all the healthcare professionals, and members of the public – all potential patients. 
But it must produce a ‘care plan’ rapidly, for the ‘patient’ is now ‘an emergency’.
We must ensure that the NHS survives – it is too valuable to lose. But we must ensure that it is fit for purpose in the 21st century. 
I am sure that all health care professionals would echo Mr Churchill’s famous words (delivered in a different context!): “Give us the tools and we will finish the job.”
MALCOLM MORRISON
Retired Orthopaedic Surgeon
Prospect Hill, Swindon