As a long-retired surgeon I usually enjoy the weekly comments by Dr Des Spence. However, I was saddened to read his recent caricature of the difference between private and NHS medicine (BMJ 2012;344:d8352). Dr Spence strangely accuses the private sector of being monolithic but it is the NHS which turns away cancer patients if they have the temerity to take some private treatment.

As a consultant at St Mary’s, I was chairman of the planning committee for the new hospital for most of my working life, taking much free time. After several years we were told with no explanation or reason that the plans had been cancelled. Over the same period the private Wellington Hospital made plans to build a new wing. It was thought that our expenses on architect’s fees, quantity surveyors and the like were similar to those of the Wellington Hospital which achieved a splendid new building while we had nothing to show. This wasteful process was repeated several times before a hospital was finally built. I learned of many similar experiences from colleagues around the country.

I enjoyed a private practice which gave the great pleasure of being able to treat patients more efficiently than in the NHS. I enjoyed the supplemental income but, like my colleagues who had a referral practice, I spent much time, to my financial detriment, advising patients against the surgery which they had been recommended.

Such experiences demonstrate the ability of the NHS to retard progress and it seems important to look widely at other systems, particularly in Europe when planning the future.

Competing interests: None declared