YOUR health correspondent Helen Puttick has confirmed that the SNP has persistently broken a 2007 manifesto commitment that there would be "no place for the private sector in the NHS in Scotland" ("NHS Scotland spent £7m to send patients private", The Herald, March 20).

The sums transferred from the National Health Service in Scotland (NHSiS) to private providers are greater than even I imagined at £35m a year; enough to run the annual orthopaedic and trauma service for several health boards combined.

Health Secretary Alex Neil persists in denying the evidence of the failure of the SNP Government and the previous Health Secretary to address the structural failures of the NHSiS, resulting in the requirement to use the private sector for surgical work which could be accommodated in the NHS if waste and duplication of unnecessary services were addressed. Consultant time is often the limiting factor in the provision of elective surgical services.

The requirement to duplicate benign and undemanding on-call rotas on multiple sites, resulting in consultants having paid time off work of up to one-and-a-half days a week as compensation for that on-call, severely restricts the ability of services to provide elective care.

Costs are multiplied and work has to be sent to the private sector, ironically to be done by those same consultants who are having time off in lieu for their NHS on-call. Many on-call rotas may be arduous, but many are not.

The majority of NHS work done in the private sector is orthopaedic surgery, and the Scottish orthopaedic community has campaigned for years to have more surgical capacity, operating theatres and staff, provided within the NHS to allow surgeons to operate on their patients in the health service and reduce to a minimum the transfer of patients to the private sector, often far from their homes and relatives.

A major proportion of the recurrent annual £35m NHSiS spend in the private sector, if invested in long-term NHS staff and facilities, would abolish any requirement for NHS patients to be treated in the private sector, to the benefit of all. However, it is apparent that the Scottish Government has neither the imagination, courage nor willingness to do other than throw our money at the problem for short-term political advantage.

This is a scandal which should not go unchallenged.

Gavin R Tait,

37 Fairlie,

East Kilbride.