Martin Rathfelder, director, Socialist Health Association Foundation trust regulator Bill Moyes is quite right to raise questions about democracy and accountability in the mixed health economy (news, pages 5-7, 9 June).

We have been calling for elected and accountable primary care trusts since they were established. It is hard to see how anyone can defend the existence of boards full of appointees as representing anything more than a token of accountability to local people when it is obvious that PCT boards are accountable only to the health secretary.

Only an elected PCT board will be able to shift resources out of hospital and back into the community and public health. Only the existence of an elected board will give politicians enough cover to let unwanted hospitals close without stepping in to rescue them - and then only if no elections are imminent.