Your article on the decimation of Kidderminster Hospital ('Polls apart, ' news focus, 8 July) exposes the arrogant attitude of Worcestershire health authority chief executive Pat Archer-Jones - a doyen of the 'stonewall' school of public relations that has made 'consultation' such a sick joke in the NHS.
But, like the toothless King's Fund response to the plan, the article fails to tackle the central, unresolved issue of frontline hospital beds.
This is one of the many questions on the viability of the Worcestershire plan which throughout the consultation period Ms Archer-Jones and her colleagues stubbornly refused to answer, and which the judicial review judge outrageously refused to allow campaigners to ask in court.
The HA has admitted that its plans involve a 27 per cent reduction in acute beds across the county. Such large-scale and rapid reductions are without precedent. Only 12 per cent of NHS acute beds closed nationally in the 12 years to 1995, during a period in which rapid growth of day surgery was reducing the need for beds.
The increased use of day surgery has run alongside a steep increase in medical admissions to hospital - which now outnumber surgical admissions. Three-quarters of medical admissions are emergencies, and their average length of stay is longer.
These changes mean that the number of patients per bed per year - which rose rapidly from 38 in 1986 to 51 in 1993 - has increased more slowly, averaging just 55 in 1997-98.
The Worcestershire plan ignores these national trends, assuming an increase of over 50 per cent in patient throughput. Neither Ms Archer-Jones nor her colleagues have bothered to answer those who have challenged the viability of these plans, on which their projected 'savings' depend.
The danger remains that once the bulldozers have taken their toll, residents in Wyre Forest and Redditch requiring emergency admission will face not only a longer journey to Worcester, but the near certainty of a long queue for a bed when they get there. This was a key reason why the ludicrously-named Investing in Excellence document was unanimously opposed last year by all political parties in Wyre Forest council, and rejected by the county council.
Ms Archer-Jones makes clear her eagerness to hack back Kidderminster Hospital and her contempt for anyone who disagrees with her. But of course the Health Concern councillors she derides represented a broad local consensus against her. Unlike her, they have sought - and won - a democratic mandate for their views from the electorate. Who does she represent?
Only by hiding behind the unaccountable quango system of the NHS - and the arbitrary decisions of ill-informed ministers and judges - have Ms Archer-Jones and her team been able to force through their unpopular plan.
It could yet prove disastrous for the people of Worcestershire.
John Lister Information director London Health Emergency