Re Wes Streeting’s ambitions (Wes Streeting defends Labour plan to use private sector to cut NHS backlog, 12 April), I worked two sessions a week as a GP specialist in endoscopy at our local NHS hospital. Two things were a constant source of irritation. First, the work was poorly remunerated and did not cover my absence from my practice. Second, the lists I worked were sub-optimally organised, with elective outpatient cases mixed with emergency inpatient cases, causing several patients long waits on the day of their endoscopy.

Consequently, myself and colleagues established our own community endoscopy service purely for NHS patients. From the start we offered transnasal gastroscopy, which is relatively new, results in less gagging, and seldom needed sedation. We developed a seamless referral service to secondary care for those who were discovered to have cancer to avoid any delays in assessment and treatment. From the start, our mantra was service, quality and training. It is a fine model of an innovative private service that is offering first-class care to the NHS.

There are those who will never accept a relationship between the private sector and the NHS on ideological grounds. They may like to acknowledge that the current GP model is also essentially based on a private service in that GP partners pay their staff and are themselves remunerated by the profit generated by their practice. In my view, the NHS as it currently stands is unsustainable. It needs help and support from other providers, as long as they all come up to the mark.
Dr Mike Cohen
Retired GP and GP specialist in gastroenterology, Bristol

Wes Streeting indulging in social class one-upmanship is insulting and dishonest. “Middle‑class lefties” is the language of Tory derision and smug populist inverted snobbery. Does he really want to alienate the middle class, or those with left-leaning sensibilities? Does Labour’s eagerness to build an electorally bulletproof facade now require adoption of the Tory lexicon of othering, monstering and alienating?

The fact that Streeting has also employed the meaningless euphemism “working families” when, presumably, he is referring to working-class people, hints at an arm’s-length relationship to an allegiance that dare not speak its name. As a Black, putatively middle-class, leftwing man of working-class, immigrant origins and culturally Catholic tastes, I see no contradictions in having multiple identities – aren’t we all multilayered? I therefore see no reason why Streeting needs to disown his middle-class, politically left credentials in order to claim working-class authenticity, unless, of course, his is primarily a strategic faux class solidarity.
Paul McGilchrist
Cromer, Norfolk

I see that Wes Streeting has said that it would be a “betrayal” of working-class people not to farm out more NHS services to the private sector. As a working-class man and lifelong Labour voter, I would say that the betrayal of the working-class is being led by Streeting and the Labour leadership.

Would he consider taking privately owned resources into public ownership? This would be a much better, and in the long term financially better, solution to the current backlog. The NHS’s problems are down to systematic underfunding, privatisation and outsourcing. Labour’s proposals look like good money after bad.
Martin Coult

The reason I can be described as a middle-class lefty rather than a working-class left-behind is that the consensus governments of the 50s, 60s and, yes, the 70s looked after me and opened up an educational path for me. What does Wes Streeting hope to gain from insulting older Labour supporters, who look back and see a fairer society upended by the steady incursion of the private sector into what used to be public? Ominous too to see that Peter Mandelson is back sneering at what many would assume to be core Labour values.
Nick Langley

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