REGARDING your editorial discussing a long-term solution to 'the ills of the NHS' (LET, June 1), as a hospital doctor at the front-line of healthcare delivery, I am anxious to try to respond to the enormous and often grossly-unfair medical representations of our health service, especially in recent months.

The National Health Service, as it exists today, is largely unique within global healthcare provision. It is funded entirely from general taxation and provides nearly completely-free care, regardless of a patient's financial circumstances.

The services available include those at the cutting edge of medical technology, which rank alongside those of countries with significantly higher health spending per capita than ourselves. There are few, if any, other countries which provide an equivalent range of services as here, with such a small input from the independent sector.

The politicisation of the NHS is, I am certain, something which angers many NHS employees. Funding issues are, of course, of paramount importance, but waiting list figures, which both Labour and Tory politicians see as a kind of holy grail, are given far too much emphasis.

We have rates of preventable, 'lifestyle-related' disease in this country as high as, or higher than, anywhere else in the world and waiting list initiatives do virtually nothing to alleviate this.

All political parties may at this point wish to realise that the amount of funding required to bring the NHS into line with the United States is far in excess of that which the British middle classes will ever be prepared to pay in tax increases. The ultimate solutions are, I am afraid, unpalatable. Firstly, rationing, which any politician you speak to will deny exists, is a reality, and the only reason the NHS continues to operate -- This means waiting lists.

Secondly, enormous expansion of the private healthcare sector is required in order to provide the consumer-oriented healthcare system which is now demanded by our clients.

In my own experience, the recent flurry of media 'NHS-bashing' has brought about an increasingly complaint-oriented and aggressive attitude from many users of the NHS and their families toward NHS staff.

In any situation where an outcome is unfavourable, such as the death or deterioration in condition of a loved-one, we are now seeing formal complaints issued, often claiming incompetence on the part of those who provided the care.

I will be the last person to claim that we are perfect, but I am quite certain that for every under-performing NHS employee, there are 10 performing beyond the duties required of them and working in excess of their contracts.

If performance-related pay is to be introduced, then I for one am all for it, since it may perhaps mean that the embattled and embittered staff of our once-great NHS, principally the nurses, might finally be given what they deserve.

R P GRAYSON (Dr), Roman Road, Blackburn.