Wes Streeting does not seem to understand the complexity of healthcare funding. League tables will exacerbate regional differences rather than abolish them (Norfolk hospital worst in country as NHS league tables reintroduced, 9 September). The problems are not unknown but, sadly for this government, will not be solved in the next four years. It should not be a surprise, especially for Mr Streeting, that the NHS cannot function efficiently until social care is fixed.

There is a massive shortage of staff in all specialities, which take 10 to 15 years to get from university to skilled professional. This leads to a reliance on locum and agency staff. The hospitals at the bottom of the tables will have the highest usage of them, reducing quality of care at a higher cost. Increasing the use of private clinics simply loses staff from the NHS.

The solutions are neither quick nor easy. Prevention, which is the best way to address demand in the long term, needs cooperation between government departments, something that has not been seen for decades.
Dr Michael Peel
London

The new scoring system of NHS trusts, especially regarding mental health care, may be too simplistic. Within the past year, I’ve had a mental health admission involving a transfer of care from one trust to another – the care at one ward was much better and well rounded, despite this trust having a lower rating by two points. While this rating may be based on the trusts’ finances, I worry that it could create fear for people coming under the care of a mental health service, something that is already such a difficult process.

The care within the same trust but in different services and wards is so varied. When a health trust provides so many different services, is it really fair to combine it all under one number?
Name and address supplied

I have read about the new league tables for local hospitals and how they will be accountable for their performance on a range of metrics such as appointment waiting times. Has this had an effect on my care? As a sufferer of skin cancer for more than 30 years, I have had six-monthly checkups and treatment for all of that time until now, when my consultant told me that, due to a growing waiting list of new cases, my future checkups would be extended to nine months instead of six.

Over the past 30 years my treatment has comprised cutting or freezing lesions on a regular basis. Now I am being exposed to the risk of missing out on a critical diagnosis in time for treatment. Is this an example of hospitals concentrating on how to boost their rankings instead of on existing patients?
Bill Mason (100 years old)
Beckenham, Kent

A rating for an entire hospital based on 30 metrics is no use to me if I need elective surgery. There can be five to 20 surgical departments in a large hospital. Outcomes for elective surgery will vary between them and between individual surgeons. The waiting times may vary by condition if some surgeons tend to specialise. Overall, it’s the wrong rating for a complicated choice.
Peter West
Health economist, London

Our local Medway NHS trust was fifth from bottom in the acute trust league table, but recent experiences of myself and friends at the hospital have been excellent. Indeed, I received a letter offering a follow-up appointment date within two weeks of returning a self-test kit.
Ralph Jones
Rochester, Kent

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