Who should we blame for the shocking cuts to jobs and services at the Lister and other hospitals? Is it the thousands of patients who clearly have too high expectations for their medical conditions, like a friend who was refused treatment for her varicose

Who should we blame for the shocking cuts to jobs and services at the Lister and other hospitals?

Is it the thousands of patients who clearly have too high expectations for their medical conditions, like a friend who was refused treatment for her varicose veins? Perhaps it is the hundreds of hospital staff, many of whom will now lose their jobs. Has their productivity been so awful over the last few years?

As I have some recent experience of working at a senior level in the NHS could I suggest where the finger of responsibility should point?

The Trust's own website reveals that they are managed by a board of 14 directors - most on or near to six figure salaries. The relatively modestly paid Dad's Army of so-called non-executive directors, predominantly from the private sector, seem to have brought little to the local health service. Below them you will find a multi-layered legion of assistant or associate directors and directorate, general and section managers, coordinators and administrators. All large organisations need management, but many are not the sign of a healthy organisation.

Cuts of this magnitude represent an acute and chronic failure of both strategic and operational management. Senior members of the board should consider their position or surgeons' management, cut thyself!

Finally with the massive sums poured into the NHS since 1997 surely we should expect Barbara Follett MP to be more challenging of the causes and consequences of this crisis.

NAME AND ADDRESS WITHHELD

* I have just been treated at the Lister Hospital and can only praise the treatment that I received there. Such a kind, caring group of people you could not wish for.

Therefore it comes as a shock when I read in The Comet that 500 posts are to go and wards shut. This cannot be right, I hear at the same time on the news that billions of pounds are to be spent on an update of Trident nuclear weapons. How can such sums be spent on useless toys that could never, one hopes, be used and cut back on the NHS? If the money is there to buy such toys, then the money must be around to pay for hospitals to be used by the people of this country. When I think what several billion pounds could be spent on, then read that jobs in our Health Trust are to be lost through lack of money; I am in dismay.

JOHN DETTMAR, Letchworth Garden City

* I grew up with the message 'buy British' and the belief that the NHS was a national institution of which we could be proud.

The PCT and East and North Herts NHS Trust have a responsibility to the local community at all levels, from patient care to employing local staff and supporting the local businesses.

What will the loss of 500 jobs do to the local economy? What hope do these people have of getting suitable jobs nearby? Why are our local MPs not standing up to the gross mismanagement which has seen the care offered by the PCT and Trust deteriorate over the last couple of years?

We read the hospital is now sending work to India at the same time as losing 500 posts. My health has already been put at risk by a typing failure in India which meant my doctor was not informed of a change in my prescription. No one could find my medical records because there are no longer enough clerks and records apparently sit in piles waiting to be filed. I had to make a fuss for two days to get the details sent on. How long before an error causes real harm to someone?

A search on the internet showed outsourcing typing of medical letters has been tried and failed at great cost in other NHS hospitals. The managers at East and North Herts Trust must know this so why are they pressing blindly on with such blatant stupidity?

When will senior NHS staff and the government realise that patients want to receive a high standard of care in their local hospital? What is the point of closing wards when there are not enough beds for patients in the winter? We do not need private centres or to travel for miles to get treatment which has been available from brilliant staff in Stevenage.

East and North Herts Trust should stop wasting money on the misguided chief executive and expensive management consultants. If the incompetence continues, there will be no NHS care left for any of us.

NAME AND ADDRESS WITHELD