While Alan Maynard's 'tonguein-cheek' suggestion of reducing the royal colleges to three (Opinion, page 20, 29 March) may never be carried out or - with so many empires to protect - even considered, it nevertheless suggests a possible way forward for the diagnostic clinical services.
The NHS plan variously proposes a common titling/career structure of healthcare scientist for 35 clinical service disciplines (Making the Change: a strategy for the professions in healthcare science, Department of Health, February 2001), as well as the introduction of diagnostic and treatment centres (Investment and Reform for NHS Hospitals: taking forward the NHS plan, DoH, February 2001).
With privatisation of clinical services now in progress under the private finance initiative, if each service is not to become further geographically divided by being in separate private groups, the development of national standards centrally controlled is now vital. Perhaps, therefore, clinical services groups should follow the path of pathology - where all the professional groups have joined in a pathology alliance - and they themselves (or the government) form a diagnostics alliance.
Of course, this would require a chair of extreme neutrality, not afraid to ask penetrating questions and with an empirebusting approach. Then and only then would the NHS and its patients gain from a focused, centrally standardised and coordinated approach to the application of modern technology bringing quantified benefits to treatment regimes and outcomes.
Having over 50 years' experience of the uses and abuses encountered in healthcare, and not being afraid to highlight sensitive problem areas, I naturally offer my services for this position. But I am not holding my breath for a show of interest in this outrageous suggestion - although I suspect the wheel was called outrageous by the 'drag-italong' tribes when first proposed.
Dennis Huckerby Principal Dee-Aitch-O Consultants Basingstoke
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