Your readers should know that the British Medical Association has three representatives from a total of 20 on the Department of Health's advisory group on consent - as many as all patients and the general public combined. No wonder 'keeping an advisory group manageable' creates conflict.

There are two types of foul-up:

actual foul-up and PR foul-up.

The Alder Hey scandal fits the first definition; tokenistic patient consultation the second. Health secretary Alan Milburn spoke to the Long-term Medical Conditions Alliance only last month on 'a new bond of trust between patients and the NHS' focusing on the importance of consent.

The DoH's response is to insult the patient movement by failing to establish a genuinely balanced advisory group which does justice to patents' concerns and needs in giving their agreement to medical treatment, or indeed the removal of organs, for whatever purpose. Apparently ever more 'guidelines' will eventually appear, adding to the mountain already in existence.

Only appropriate regulations will actually restore public confidence that informed consent means more than 'doctors inform, patients consent'.

This is a very unhappy situation for patients, the public and medical profession, many of whose members are working so hard to give substance to the concept of doctor-patient partnership.

Roger M Goss Director Patient Concern