I have just returned home after a hip replacement operation at the Westmorland General Hospital at Kendal.

There is no doubt as a business woman (now retired) I could identify, like your correspondent Louise Broughton, areas of inefficiency and waste. (Letters, November 9, 'Privatise the health service').

However, I always remind myself of the fact that the NHS is the most cost-effective health care system in the world with lower spending as a proportion of GDP than most comparable countries. I doubt Richard Branson, with his need for a healthy profit, would want to take this on except as a cherry picking exercise.

The NHS is under unprecedented pressure from higher demand, increased expectations and an ageing population. More investment is needed together with continued vigorous review and reform.

During my recent stay I was cared for by an excellent team of professionals and support staff in a warm and friendly atmosphere. I would like to thank them all.

Jean Wood