Published: 08/01/2004, Volume II4, No. 5886 Page 25

HSJ claims that the 'fateful decision on failing primary care trusts can't be put off forever - or many will conclude that they are simply the wrong organisations for the job' (Comment, page 15, 20 November).

While there is probably something for everyone in the editorial, it will help sharpen the claws and beaks of those in the system who cannot wait for PCTs to fail so they can pick over the corpses.How would the first generation of acute and mental health trusts have fared if they had been star-rated one year on in the early 1990s?

What the new-style 2003 PCTs need is a period of continuous organisational history and consistent corporate governance to do their jobs.

The Department of Health has rightly concluded that franchisers or strategic health authorities could not step in and do better.

Acute trusts with three stars and foundation ambitions have had 10 years' continuous organisational history to make mistakes, learn and then succeed.

Even in football, it has taken Arsene Wenger eight years to take Arsenal where they are today.

David Cox Chair South Birmingham PCT