I almost agree with Gavin R Tait, but he cannot blame any one Government (Letters, December 24).

I seem to recall NHS Greater Glasgow and Clyde (NHSGGC) a few years ago paid £6 million to fast-track patients through a private hospital to meet waiting time targets. In fact NHSGGC liked the hospital so much that in 2002 it bought it – admittedly a bargain at a fraction of its cost – and called it the Golden Jubilee. All this under an earlier Scottish Executive of a different (and fetching two-tone) stripe.

Targets are a valid way of driving many commercial enterprises, but they are generally only used when workers' loyalty to their employer or to their calling is no longer sufficient motivation. It has apparently not been possible for the NHS to consult properly with clinicians and others whose efforts are supposedly to be guided by these apparently god-given principles. The result is declining morale in a health care system where staff attitudes to work and patients is vital.

The NHS, for reasons as Mr Tait says often of political interference, has lost much of the loyalty of 60 years ago. Advances in medicine and surgery have been complemented by progress in clinical skill sets of world standard, yet the NHS has been starved of the management ingenuity and independence to allow proper use of SMART targets, without which those clinical skills may not be effectively exploited.

A clinical services review is now in hand, which may open the way to greater collaboration within the NHS and with the patient, and perhaps one element can be introduced to bridge gaps: increase the patient's involvement with his/her care by all means, but the system will always be complicated to an outsider and each patient should have one single named member of NHS staff who has responsibility for their case: a guide through what is often a bewildering maze of forms and uniforms, places and faces.

A name with a face. And a telephone number.

James Sandeman,

3 Scone Place,

Newton Mearns.