I EMPATHISE with Dr Bethany Jones regarding her comments (“EX NHS doctor: Target culture is harming patients”, The Herald, November 5). I retired in 2009 as a consultant neurologist working in Glasgow, Lanarkshire and Western Isles; the last location being best, remote from ambitious bullies.

Target culture had emerged and waxed before I retired. Review appointments were curtailed. I taught medical students for decades, training them to cope rather than to care (cope equates to competence, care to emotion). Inter alia I informed them that second and subsequent contacts with a specialist doctor were generally more significant than first contact, each case evolving in terms of management (diagnosis and treatment). However, second and subsequent contacts are now rationed, an emotive word politically.

Furthermore teaching of medical students by experienced doctors is diminished because experienced doctors are required to spend more time in direct patient contact in order to meet targets; long-term adverse consequences ignored, the public being aware of targets and claims made by politicians about targets but being unaware of compromise of medical training. Populism?

With benefit of mature hindsight – of course we are all geniuses with benefit of hindsight – the SNP in government will be perceived as catastrophic for NHS Scotland and for medical education in Scotland.

Having moved to the other side of the world to live and work, but providing adverse comment five years after leaving NHS Highland, suggests that Dr Jones bears lingering psychological scars from her period of employment by NHS Highland. She indicates that “she loved and still misses providing healthcare in the Highlands”; but clearly not enough to remain. She did not love management; nor, I infer, did management love her.

The bullying culture in NHS Scotland trickles down from the upper echelons of the political world in Scotland.

Dr William Durward,

20 South Erskine Park, Bearsden.