I read with little surprise your article about the blatant exchange of views following objections by South Birmingham CHC concerning the city's aspirations for a modern healthcare facility for the next millennium (news focus, pages 10-11, 12 August).

Birmingham health authority has conducted a near exemplary and - inevitably - painful consultation with the public and groups representing legitimate sectional interests.

In seeking to ascertain the views of Birmingham residents, the HA formulated a number of questions (not answers), revised its original consultation document after initial feedback and commissioned an independent 'citizens' jury' which was chaired by Lord Hunt to take evidence from organisations and healthcare professionals across the city. Furthermore, numerous meetings have taken place with community and ward groups and the two main papers (the Evening Mail and Birmingham Post) have been active participants in the debate.

The consultation hasbeen meaningful and effective, and we should take heart that the local democratic process enables individuals and organisations to take different positions.

The inevitable dichotomy that may always exist whenthe public are asked to participate in developing healthcare strategies and making difficult healthcare choices should be acknowledged but certainly not dramatised.

Mark Britnell

Executive director for operations

University Hospital Birmingham trust