David Stelmach (Letters, 15 October) feels it is not the role of the Society of Radiographers to influence trusts in their choice of cost- efficient ways to acquire technology. The society would argue it owes such a responsibility to the professions operating in medical imaging and oncology, to the healthcare services in the UK and - above all - to the general public.

The society is concerned that the private finance initiative is ill-conceived and the present government knows it to be so. The capital technology of the NHS is in such a neglected state that large investment is needed just to stand still. We all know this, but the Treasury has other priorities for the pennies in the public purse. Instead we believe that this government has reluctantly opted to retain PFI for short-term gain knowing there will be a high price to be paid later, and that will come from the public's pocket.

The society keeps asking a simple question and no satisfactory answer is forthcoming. Perhaps your readers can help - either by answering our concerns or by joining in the rising clamour.

The question is this: 'If industry can build and equip NHS facilities and still walk away with the profits, why can't government resources do the same for less?' A naive question, perhaps. But the lack of a credible answer makes us nervous.

Public money will leak away into the private sector as the direct consequence of PFI. Major projects will bring huge financial paybacks to industry years down the line. Often the facilities purchased through these schemes will be long redundant by the time final payments are made. The NHS will still have to renew these facilities and so is hooked into a vicious circle of remortgaging.

There is extraordinary complacency at every tier of the NHS on this issue. Managers, to square the financial circle in the short term, are falling for PFI in the same way the government has - a quick fix and hang the consequences.

We have another concern too. If private industry bank-rolls these technologies, it will expect the right to supply the staff that use it. How long will those staff remain recognisably similar to the high-quality professionals of today's NHS? Not for long when profit drives the system. Mr Stelmach should think about that. There is no law in this land that says a radiographer must press the button.

Stephen Evans

General secretary and chief executive

Society of Radiographers

London NW1

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