Published: 30/05/2002, Volume II2, No. 5807 Page 22

It is sad that franchising, as a potential lever for 'raising performance in the NHS', should be tainted at its first use. Hospitals that are listed as the 'worst four' in the country and the top priority for franchising support, deserve better than part-time chief executives.

Yet part-time top managers are what two of the trusts have been awarded to deal with their 'persistent problems with performance'.

Ashford and St Peter's Hospital trust appears to have fared even worse. A confused splitresponsibility regime is proposed.

For the first 12 months of the franchise, it will be managed by an interim part-time chief executive whose attention will be 50 per cent devoted to his other hospital, to which he will then return.

During the first year he will be supported by a chief executive designate, who may well be very competent, but the arrangements make him appear to be an assistant.

This irregular management arrangement does little to boost community confidence.

Health secretary Alan Milburn describes the new chief executives as having 'won' their franchise.

Who, one must ask, applied for the Ashford and St Peter's Hospital trust franchise and lost?

Is the health service really so devoid of talent, or are the terms of a franchise so unappealing?

Tom Brooks Walton-on-Thames Surrey