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The growing crisis in Accident and Emergency (A&E) departments is the result of government policies, as well described in the Socialist (8 January).

Simon Carter gave four key reasons for A&E departments becoming overwhelmed by patients - difficulty getting a GP appointment, shortage of permanent A&E staff (which is partly due to cuts in nurse training but also because working conditions are becoming intolerable so staff leave), cuts to social care and closure of A&E departments.

Another important reason is NHS 111 - the number for less urgent calls than 999. The service was provided by NHS Direct but privatised in 2013. Care UK is now the biggest provider, running 20 of 45 call centres.

NHS Direct spent an average £13 per call. That was cut to £7-9 a call, by cutting clinically qualified staff. Instead of most call handlers being trained nurses, there are now as few as one nurse for 25 call handlers. To cut the risk to the company of being sued for wrong advice, patients are directed to A&E more often. The publicly owned ambulance and hospital services have to pay out so privately run NHS 111 centres run profitably.

Jon Dale