In Andrew Wall's otherwise excellent article, when he discussed who would manage primary care groups, he comments: 'Such managers can presumably be found from redundant HA staff'. Nowhere does he consider existing primary care managers as being part of the new management arrangements.

This is, I fear, a reflection of the prevailing view of health authority managers who are keen to extend their power over those working in primary care.

So much for the flavour of last month, 'a primary care-led NHS'.

Paul Kemm,

General manager,

The Field Road Surgery,