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The review by Niall Dickson ("An all-out attack on a managerial cancer", June 10) of Allyson Pollock's book NHS Plc: The Privatisation of our Health Care reads more like a gutter-press diatribe than an academic review. In contrast to the text itself, Dickson's interpretation appears wild and disturbed, with exaggerated allusions to Machiavellian plots and governmental corruption.

Pollock makes a brave attempt to untangle the changing financial processes of National Health Service funding. While her analysis of the logical outcome of applying an inappropriate business model will offend blinkered adherents of management culture, it should be properly appraised.

Hopefully, Times Higher readers will recognise the analogy with changes in higher education. Now that universities are run like businesses, we have management appointees frequently inexperienced in academic work but overruling lecturers and researchers in day-to-day academic decisions.

Professionals at the workface in healthcare and education want to be free to deliver a good-quality service and can bear witness to the inhibiting effects of commercial constraints. Long-term comparisons across national boundaries, anticipated by Dickson, are unlikely to convince these people of the benefits of adopting a quasi-market.

Janet Shapiro
Retired, London Metropolitan University