I WRITE in reply to your coverage of the NHS 24 fiasco over the past few days and also in response to comments (February 24) by Jim Devine of Unison. NHS 24 is an initiative which has been brought in to service the needs of a massively evolved healthcare system, replacing an outdated and underfunded system of doctors on call. Of course it will have teething problems, but does this have to turn into back-biting and handbags at 10 paces in the media?

Jim Devine states the major problem is not the nurses staffing NHS 24, not the management controlling it all and not the Scottish public. Instead, he blames the medical profession and its "constant carping" and lack of recognition that nurses are now doing many of doctors' duties.

This is patently not true and another example of laying the blame at someone else's doorstep by a public figure who should know better.

NHS 24 is a valuable and necessary service. Those nurses who work in it are doing the best job they can. But these are people getting a massive pay-rise from ward or community-based jobs they have come from and where they have left huge skills gaps. It is doctors and their ex-nursing colleagues in A&E departments around the country who pick up the pieces of NHS 24 disasters and mismanagement.

It has been estimated by some consultants that A&E admissions have gone up by 50-per cent since the advent of NHS 24, thus having the exact opposite effect to that intended. The advice offered is often so poor and badly communicated that patients take themselves up to A&E inappropriately or are in fact inappropriately sent there by NHS 24 staff too scared to make a judgment.

This is not an indictment of the staff, merely an observation at the failings of the system.

According to Jim Devine, 95-per cent of the time patients are satisfied with the advice they receive from NHS 24. Ask any junior doctor on an A&E night-shift how many bad referrals they get from NHS 24 and you will probably also receive a figure approximate to that one.

The public are very bad at knowing what requires to be seen by an A&E doctor. Recent examples on a night-shift include:

a mouth ulcer, a nine-month history of back pain and a neck lump which they had just noticed.

Education is what is needed - both for the public and for NHS 24.

Dr Sandy Nelson, junior hospital doctor, 60 Partickhill Road, Glasgow.