letters :

Roy Lilley's letter (28 June) on the NHS's increasing use of the private health sector overlooks, as does the government, the opportunities for the NHS through its own pay-bed provision.

There are about 3,000 pay-beds in the NHS, of which half are in 86 dedicated pay-bed units. The growth of pay-bed revenue to trusts has been impressive, averaging 14 per cent annually over the last decade. Private treatment in NHS hospitals amounts to£331m a year, some 15 per cent of the total private sector market. Being located at district general hospitals, such units have considerable advantages, such as access to round-the-clock specialist doctors, comprehensive diagnostic and therapeutic facilities as well as convenience for consultants who can perform their NHS and private work on one site.

With relatively flat demand for private medical insurance but growth in the self-pay market, the NHS could compete with the private sector, not only for private patients but for additional NHS waiting-list patients funded through government initiatives.

The capital needed by the NHS to expand and modernise its pay-bed facilities could come through private finance initiatives as it does increasingly for mainstream clinical developments. The concordat between the government and the private health sector is welcome - there can be no place in the modern health system for ideological dogma and prejudice.

Public funds going into the private sector, however, must produce value for money. The best way of ensuring this is a two-way street.

Dr Alan Davison Tollesbury Essex