Published: 15/07/2004, Volume II4, No. 5914 Page 21

I read with interest Graham Clews' article headed 'Trouble dead ahead as SHAs pull the PCT levers too hard' (The Big Story, pages 12-13, 24 June).

I was comforted to find that on this rare occasion both the National Association of Primary Care and the NHS Alliance share very similar perceptions of the relationship between many strategic health authorities and primary care trusts, although NAPC's views were not canvassed.

However, far from NHS Alliance chair Dr Michael Dixon being a 'lone voice' (Speak out, page 23, 17 June) addressing concerns about the pressures to which PCTs are subjected by some SHAs, NAPC has repeatedly expressed alarm in meetings with both ministers and the Department of Health on this issue.

NAPC has also expressed its concern that such pressure could derail the government's policy of a primary care-driven NHS.

Not all negotiations are made public, Dr Dixon.

Maggie Marum Consultant to the National Association of Primary Care