Having enjoyed more than half a century of the NHS, we tend to think that in any developed country effective healthcare would inevitably be available to all of the population.

It is sobering to find that a World Health Organisation global survey ranked the health provision in America as the highest in cost, but as only 72nd in overall level of health provision. Life expectancy at birth in the US is 50th in the world and the infant mortality rate is higher than that in most industrialised countries. About 17 per cent of the US population is without health insurance.

These figures are of concern to all your readers as many medical and legal analysts consider that the Government's Health and Social Care Bill (the NHS "reform" bill) presently going through Parliament "will end entitlement to comprehensive healthcare in England, paving the way for the introduction of a US-style health system with competitive markets and structures consistent with greater inequality of provision, mixed funding, and widespread provision by private health corporations" (The Lancet, January 26). Perhaps a foretaste of what is to come is the scandal of silicone breast implants by private health providers "more concerned with costs than with quality".

The Health and Social Care Bill has gone through most of its parliamentary stages, but it is still not too late for us to urge our MPs to act to save their constituents from a healthcare system based on competitive markets, mixed funding and widespread provision by private health corporations which leads to greater inequality of provision to the detriment of the human dignity of most of their constituents and of their children.

DAVID PACKHAM

Lippiatt Lane

Timsbury