SIR - There must have been a vast change in the NHS if it can fairly accuse us patients of wasting staff time by not turning up for appointments.

In my experience, it was almost always the patients who spent days sitting in bemused circles trying to keep each other's spirits up while wondering why they all had been given a 10am appointment and noon found them none the wiser as to whether they would ever be seen.

As to the quaint consumerist idea that mere patients could get away with politely enquiring what was going on and whether 'doctor' had even arrived - well, as I say, there must have been a vast change!

So NHS staff must forgive older patients if they fail to realise that anyone in the NHS would know or even care if they attended or failed to arrive for an appointment at all.

As to the comical idea that doctors and nurses sit drumming their fingers if one or two of us don't turn up, don't make me laugh! After all, in our time all that a few missing patients would mean is that others might be 'seen' a bit sooner - but seldom earlier than our appointment time.

The NHS ushered a new aristocracy into English society in the 1940s and it was doctors who we were all expected to doff our caps to while in the NHS we patients were treated like the lower orders well into the 1980s.

If all the snobbery, indifference and arrogance we patients endured is truly over then I say hooray for that but I hope NHS staff will understand if older patients are not used to an NHS that knows or cares whether we miss our appointments or even if we are alive at all!

JIM EVANS,

Worcester.