Your piece on independent sector treatment centres, 'ISTC contract guarantees will saddle NHS with £187m bill', misses some fundamental points, writes David Worskett

First, the investment required to deliver new, state of the art medical facilities is very considerable. No one would contemplate making such an investment if the return had to be secured within five years.

Without arrangements to protect their investment, it would have been commercially impossible for investors to engage with the ISTC programme. That would have deprived the NHS of high quality facilities, improved patient care and reduced waiting times.

Second, the residual value guarantees for the ISTC programme are fair and realistic. They were approved through value for money investigations carried out by the Department of Health and the Treasury.

Third, it is misleading to focus on the hypothetical total cost if these guarantees were to be activated for all the schemes. That is clearly highly unlikely. The overall level of use of the independent centres is already at some 84 per cent of contract volume and rising, as willingness to refer to ISTCs increases in the light of favourable experience.

Finally, your report ignores patient experience. The overall ISTC patient satisfaction rate is currently over 97 per cent. Treatment centres are delivering quality patient care, in clean, modern facilities, on fair terms. That is the real "bottom line".

David Worskett, director, NHS Partners Network