It is both regrettable and depressingly inevitable that objective debate surrounding Lord Darzi's Healthcare for London vision has been blighted by practical concerns. In my experience, GP surgeries are already struggling to invest in the latest equipment, so it is hardly surprising that the prospect of having to kit themselves out with state of the art specialist facilities (x-ray, ultrasound etc) is viewed as 'pie in the sky'.

It is both regrettable and depressingly inevitable that objective debate surrounding Lord Darzi's Healthcare for London vision has been blighted by practical concerns. In my experience, GP surgeries are already struggling to invest in the latest equipment, so it is hardly surprising that the prospect of having to kit themselves out with state of the art specialist facilities (x-ray, ultrasound etc) is viewed as "pie in the sky".

The cost conundrum will be a serious obstacle to any long-term primary care strategy until there is a sea-change in attitude towards the acquisition of medical equipment. It is no longer prudent to keep capital tied up in depreciating medical assets. Some GPs already realise that asset finance, for instance, is a far more efficient way of managing costs and keeping ahead of the medical technology curve than outright purchase.

Wider recognition of the benefits of "alternative" funding techniques would instil more confidence in the sector so strategic vision can be matched by practical delivery.

David Martin, general manager, Siemens Financial Services