Allyson Pollock (Letters, 5 February) confuses two processes.

Birmingham health authority is out to consultation on an overall strategy for the health service of the city. University Hospital Birmingham trust has identified and agreed a preferred option for the development of its services on one site. The trust has not prepared an outline business case, nor is the trust out to consultation. Neither of these steps can be taken in the absence of an overall framework for the health service across the city.

Dr Pollock has still not contacted the trust to ask about, or comment on, our preferred option. She appears to rely on some internal working documents and a summary paper taken to the trust board's public meeting in September 1997. Our option appraisal identified a preferred option - no more - using a procedure laid down by the NHS and the Treasury.

I do not wish to speculate on Dr Pollock's motive for such a negative approach to the much- needed development proposals for Birmingham's health services, particularly as she comments from the rarefied academic climes of south London.

I invite her to approach us directly to help in the development of plans for future health services for this city and this trust, rather than stand on the sidelines throwing bricks. It may be, however, that Dr Pollock's motivation is more to do with opposition to the private finance initiative at all costs and nothing to do with logical health service development.

Jonathan Michael,

Chief executive,

University Hospital Birmingham trust.