IAN Crichton, chief executive of NHS 24, has quit his post only six months after his appointment (“New NHS 24 crisis as boss quits after only six months”, The Herald, February 11). NHS 24 has twice had to abandon its new IT system because slow response times were compromising patient safety. The project began in 2009 at an estimated cost of £75.8 million, later revised to £117.4m, and now to more than £125m. But is this new technology really necessary?

Doctors and nurses spend many years learning to recognise and deal with medical emergencies, but calls to NHS 24 are now taken by “call handlers” rather than by experienced nurses. Callers for out-of-hours medical help now have to endure the frustration of responding to computer-generated questions (algorithms) rather than telling their story to someone specifically trained in the art of diagnosis and able to appreciate the entirety of the caller's situation. Callers are discomfited by responding to what is in effect a machine, whereas a nurse provides reassurance and reaches a more informed decision more quickly – particularly in an emergency.

Algorithms often fail to identify impending emergencies such as sepsis and haemorrhagic shock, as evidenced by recent reports into the death of baby William Mead and in the British Medical Journal. But unbelievably they are the “intellectual property of Clinical Solutions” - a subsidiary of Capita, an international finance company – and cannot be divulged. Their content appears to be unknown even to the doctors and nurses who work for NHS 24, and no-one knows how they were created or by whom.

Drugs undergo rigorous testing before they can be marketed, and their content is clearly specified, so why not the same rules for algorithms? Opening these “black boxes” is long overdue, as is a thorough independent analysis of their costs and benefits compared with employing nurses.

John Womersley,

Retired consultant in public health, NHS Greater Glasgow & Clyde,

1 Woodlands Avenue, Kirkcudbright.