Sir - The news that the Nuffield Orthopaedic Centre is in trouble as a result of Labour's ridiculous approach to health care is desperately sad and completely avoidable (Report, December 15). The payment system in the NHS, which has packaged and simplified episodes of care so that they are bought and sold in an open market, does not work for most hospitals and is particularly bad for specialist ones.

Not only does this system destabalise our hospitals as they have no certainty of income, no alignment of costs and income and they are at the whim of the market, but it costs a phenomenal amount to administer. Health care should be concerned with the provision and service not with market forces - health care should not be a commodity to be bought and sold.

When this market madness is added to the crazy Labour / Tory idea of Private Finance Initiative where the Government somehow thinks that a private company which can't borrow money as cheaply as the Government and has to make profits for its shareholders can be cheaper than NHS ownership of hospitals, you complete the NHS disaster.

The Government is selling the NHS off to its corporate cronies to make huge profits at taxpayer's expense and to the detriment of patients, it is time to put a stop to this madness.

Stuart Jeffery, Health spokesman for the Green Party of England and Wales