Yes, we must fight to protect the NHS (Anne Johnstone, September 11). Karol Sikora demeans the NHS by referring to it as the "last bastion of communism in Europe", conveniently forgetting that it is a "national" service and the first bastion of an all-caring state. Undoubtedly, south of the border, there is an apparent move to a free-market economy that will, if not curtailed, almost certainly lead to an insurance-based, layered system which many would be unable to afford. The PFI/PPP system of funding has been shown to be a financial disaster, with costs continuing well into the future. It is only to be hoped that the proposed Scottish Futures Trust will not head down the same path.

There is nothing new in GPs and other members of the medical profession being courted by private-sector interests: when I was a GP in the late 1970s and early 1980s this was well recognised as an attempt at bribery. It is not so much that doctors and politicians need to prioritise the availability of certain drugs and treatments but also appreciate that this will affect the whole field of medicine. In all of this, the focus appears to have been on medical problems, with less attention being paid to the equally important mental ones.

However, even these new drugs, when offered to patients suffering from a truly incurable and progressive illness, may well prolong their lives for a relatively short period while they may continue to suffer the agony, psychological and physical, of a fatal illness. All patients must have the right to choose the right to live but how many of them consider their right to die.

Undoubtedly, this latter decision will be greatly influenced by the opinions expressed by relatives and friends. In the end, however, it is not their decision but the patients'. Undoubtedly, however, more government funding would be available if it prioritised its spending on such important social services as health, education, employment and balanced military needs and less on illegal wars and nuclear armaments. The Scottish government must continue to support the NHS.
Ian F M Saint-Yves,Whiting Bay, Isle of Arran.

What planet does Andrew Haldenby, director of Reform, live on (Calls to use health insurance in NHS, September 9)? He relates Olympics success to being able to afford healthcare insurance. Well, with our NHS care I think we did extremely well at the Beijing Olympics. Or didn't he notice the number of medals our athletes won, now followed with equal success by our paralympic athletes.

To propose a National Health Protection System where people invest £2000 per year is outrageous. People are struggling to meet rising costs in energy, food and mortgages. Where does he think they can find another £2000 for this scheme, which would clearly encroach on NHS services and create a two-tier system?

I would direct him to Anne Johnston's excellent article (The Herald, September 11). "It's our NHS and we must fight to protect it. Commercial practices have been distorting healthcare."

We don't want an insurance scheme, thank you. I suggest Mr Haldenby goes back to the drawing board or, better still, emigrates to the US, where healthcare is non-existent unless you have health insurance.
Margaret Hinds, Chair of the Health Service Forum SE,Glasgow.

Ms Sturgeon is "extremely pleased" with the number of surgeries taking part in the extended-hours scheme. However, it has not been mentioned that GPs signed up for this only because not to do so would have resulted in a substantial pay cut.

In addition, it has not been mentioned that the GPs providing the extended-hours service in the evening are the same GPs who take over from NHS24 at 8am each morning.

Extended hours has simply extended the GP working day from 10 hours to 12. GPs are the only group of National Health Service workers who have never had legal restrictions on the hours they work, either in length of shift or weekly hours.

Next year we will see the introduction of the next phase of the European Working Time Directive which has been brought in because of concerns about patient safety when doctors work excessive hours. This will reduce the number of hours that junior doctors can work in a week. However, full-time GPs working extended hours will then be working longer hours than junior doctors.

Can Ms Sturgeon or anyone else explain why it it unacceptable for a 25-year-old junior doctor to work more than 48 hours in a week on grounds of patient safety and yet it is acceptable for the hundreds of Scottish GPs in their fifties and sixties to do so?
Dr Morag Martindale, Ardblair Medical Centre, Blairgowrie.