Mr Russ expressed concern about the complicated mess that surrounds the prescribing of drugs (Have Your Say, June 25). Obviously it is shocking that well informed doctors are not allowed to use their expertise and judgement to prescribe, however the public needs to be aware that nowadays just about any hospital doctor can expect to be a consultant by the time they are 40 and due to this there has been an inevitable decline in standards of competence and experience.

Also, research shows that doctors are less likely to deliver currently accepted standards of care and to provide technically appropriate care as the number of years they have spent in practice increases.

Recent studies included measures of doctors’ knowledge or quality of care and the age of the doctor or the length of time since graduation from medical school.

Just over three quarters of the studies showed that a doctor’s performance declined with time. More than half showed that performance declined for all outcomes measured, while a fifth showed that some of a doctor’s performance declined with time. For these reasons, doctors, medical procedures and prescribing are, nowadays, much more stringently controlled by Nice and other bodies, and quite rightly so.

F Dougherty Edifred Road Bournemouth