Published: 01/07/2004, Volume II3, No. 5912 Page 22

It is a sign of desperate times when you have to resort to running down your 'partner organisations' to try to establish your own organisation's credentials, as the NHS Alliance's Dr Michael Dixon does (Speak out, page 23, 17 June).

Far from 'renouncing political involvement and leaving the field', at the NHS Confederation we continue to work at all levels and with all political parties.

Dr Dixon rightly says we all have a responsibility to question, to challenge and to debate and to do so openly. Perhaps the alliance should join us at the manifesto seminars we are running or read our manifesto consultation.

The results will be launched at the autumn party conferences at a 'health hotel' we have set up, which involves 26 organisations working together to promote an open debate about health policy.

The confederation will be watching closely for the new improved NHS Alliance we are promised. We wish Michael all the best with his re-launch. We wonder, can we expect Michael to be the Robert Kilroy-Silk of NHS influencing?

Dame Gill Morgan Chief executive NHS Confederation

Have the fortunes of the NHS Alliance really reached such a low ebb that chair Dr Michael Dixon has to resort to personal attacks on other organisations in order to achieve press coverage?

Dr Dixon is perfectly aware that at the National Association of Primary Care we describe ourselves as 'apolitical and nonpolitical', universally understood as meaning 'impartial' and 'not party political'.

We will in future include a simple guide to these terms on our website.

He is also aware that at the National Association for Primary Care we remain effective and active at all political levels.Our record demonstrates our successes and our consistency of message.

The alliance itself has been quick to take advantage of the benefits that have accrued through our work. Personal medical services and practice-led commissioning are both examples of issues on which we have been the only drivers despite almost universal opposition, including from the alliance.We welcome Dr Dixon's subsequent conversion in both these areas signalling a positive change in direction for the alliance.

Our members (who are aware that I have in the past been on record as supporting 'alliances' between our organisations), primary care, alliance members and others will have to decide for themselves what has been gained by this unprecedented and unprovoked attack on 'partner organisations'.

Dr Peter Smith Chair National Association of Primary Care

Unlike some other organisations the National Association of Primary Care does not sit back passively to see what sort of general practice emerges from national policy. Nor do we adopt a disinterested stance towards primary care: we have a clear bias towards models of healthcare that seize the opportunity to empower frontline staff through devolved decision-making.We endeavour to support primary healthcare teams and primary care organisations in determining their own destiny.

NAPC welcomes the debate that arises from the stark differences in opinion between itself and other organisations.We consider solely depending on constructive criticism as a mark of failure for a representative organisation rather than a measure of success.

We seek to influence the planning process at a point where it can be shaped by our critical analysis, our insight into primary care and our integrity in honouring the trust that others place in us.

We believe it is time for alliances within the NHS to be superseded by integrated services. That is why in the next year we will be focusing on unlocking the potential of practices to contribute to the development of health services through integrated care pathways, integrating community nurses into primary healthcare teams and the implementation of practice-based commissioning.

Dr Johnny Marshall Treasurer NAPC