Published: 06/02/2003, Volume II3, No. 5841 Page 25

Bobbie Jacobson makes a powerful public health case for congestion charges in London (Public domain, page 18, 16 January). All those committed to improving the public's health should wholeheartedly endorse the scheme. As the first city in the UK to introduce an access charging scheme last October, Durham considers it to have been a resounding success in meeting its primary objective - namely, a sharp reduction in the number of cars entering the city centre. From a daily tally of some 2,000 vehicles entering the city centre, there are now under 200. This has to be a significant victory for public health.

Durham, of course, is not London. But, allowing for the difference in scale, the crisis facing gridlocked cities is the same: all are having to cope with too much traffic. Even if only a small reduction in the number of cars entering the capital can be achieved, the scheme will be more than worthwhile.

I share Ms Jacobson's criticism of the myopia evident among NHS staff opposed to the scheme - a view regrettably shared by many trade unions, including Unison and the Royal College of Nursing, which should know better. But then, despite all the rhetoric, public health has never been a major priority for the NHS, which is why local government must now give a lead.

David Hunter Professor of health policy and management Durham University