Published: 06/05/2004, Volume II4, No. 5904 Page 20 21

It was good to have agreement on the importance of regional centres of excellence in medical research and development from Derek Smith and Dr Charles Gutteridge (Feedback, pages 2425, 22 April), but this cannot be attained without fairer distribution of funding.

My vision of a 'larger golden polygon' does include the three vertices of the golden triangle, but they would become gradually less dominant relative to newer centres of excellence.

As for private sector support, companies such as GlaxoSmithKline should see the potential of better value for their investment outside the triangle, as well as working with, rather than against, government aims to reduce regional economic divergence.

I agree that non-clinical R&D will not directly improve local health outcomes, but it can do so indirectly through the economy and raising the status of a trust.

Ed Macalister-Smith, in his letter, describes only the NHS R&D fund of about£450m whereas the article covers five funders totalling about£1.5bn.

It is true, as I pointed out, that the NHS fund is biased towards London and everyone else loses out because of this. I would endorse 'urgent geographical redistribution' (however, Oxford and Cambridge do receive more, for example, than most large cities in the North and Midlands).

But for the other four funding sources, Oxford and Cambridge do share with London amounts other cities can only dream about.

John Hacking Senior research officer Manchester Joint Health Unit