I FIND it disconcerting that whenever The Herald reports on a problem in the NHS, the response on these pages tends to be from retired doctors.

The tragic death of Dr Lauren Connelly ("Grieving father: junior doctor hours require urgent review", The Herald, December 9) has highlighted an untenable situation, and while the decision of the Crown Office may be legally valid, from the human point of view it does seem heartless. So far there has been no response in this paper from the British Medical Association, the Chief Medical Officer, the Royal Colleges or any other professional group, although no doubt behind the scenes, continuing efforts are being made to grapple with the problem of junior doctors' hours.

The public and tomorrow's doctors need reassurance that these quasi-compliant European Working Time Directive rotas are being reviewed urgently.

The excellent letters from Dr William Durward (December 10) and Prof David Hamblen (December 11) mention simple measures that can be undertaken to help with the problem of fatigue.

Current hospital practice may not blend with the traditional "firm" system where a consultant had a duty of care not only to all the junior staff in the unit, but also those who worked with him or her in the wards, clinics and operating theatres. In effect, these were the colleagues one met on a daily basis, and put simply and perhaps naively, meant seeing that everyone was happy at their work. Such camaraderie is so vital when working long hours in a potentially stressful environment, but does not appear to be highly valued today. Obviously, hours worked and fatigue have always been important, but it seemed possible to arrange rotas without the same imperative to make them numerically compliant with inflexible European dictats, which after all not every European country adheres to, and many of my generation abhor.

Looking in from without, there seems to be a lethal combination of all-consuming managerial pressure to achieve unrealistic Government targets imposed by politicians tainted by their priority to be re-elected, and insufficient hospital staff working unreasonable hours in an environment where professional cohesion has been sacrificed for maximum throughput on the day.

Teams have been fragmented in pursuance of politically-correct policies mandated by managers brought in from a commercial background, or it seems others with little idea of how to ensure that the staff working in our hospitals feel truly valued and cared for.

To some extent the NHS in Scotland (NHSiS) has been protected from the culture south of the Border which seems to generate horror stories on a daily basis. As it seems that the wish of the Scottish people and their politicians is to continue with a health care system of the present quality, funded essentially from taxation alone, then it would seem inevitable that additional monies must come from an increase in income tax or national insurance. Alternative European solutions involving social insurance, increased personal private insurance or indeed increased private sector involvement would not appear acceptable, or indeed feasible.

I have long questioned the current method of health care funding in the UK, and while there may not be a quick solution, the increase in doctors, nurses and indeed beds necessary to maintain our present NHSiS will require substantial extra resources. Whether, as the SNP would no doubt claim, this will inevitably follow independence, or whether Holyrood will have to provide this within the context of present Westminster funding, only the Scottish public can decide.

John Sinclair,

7 Bridgegait, Milngavie.