If, as Patricia Day and Rudolf Klein suggest, the case for regulating the NHS 'rests on the fact that the government has a responsibility for ensuring that those locked into the NHS receive quality care', why have the arguments for regulating the private sector 'much less force'?

The NHS has to bear the costs - in resources, personnel, money, blood bank use, and the postponement of its own work - of the unknown number of transfers to its hospitals in its role as the private sector's safety net.

Given the experience of regulators such as the Law Society, police authorities and those in the insurance and mortgage industries, why do the authors imagine that the General Medical Council and other professional bodies will be able to surmount perceived conflicts of interest in their regulatory functions?

If£2.35bn is spent on acute care in the independent sector, with 85,000 operations a year, then why do NHS trusts not reveal the number of operations and patients corresponding to their private patient incomes?

Since no-one appears to be monitoring the degree of subsidy represented by the independent sector's disproportionate use of NHS-trained and pensioned medical staff, the extent of private beds in NHS hospitals, the charitable tax-relief status of private hospitals and the accelerated access to NHS blood banks enjoyed by private patients, should not these items of expenditure be quantified at the very least?

D Shepherd London NW4