Published: 11/4/2002, Volume II2, No. 5800 Page 26

Having just been involved in briefing staff on the implications for central London hospitals of the Congestion Charging Order 2001, I was slightly alarmed to read that 'health service workers will not have to pay the£5' ('Pecking order', news focus, 14 March).

Either HSJ has inside information or author Nicholas Pyke believes all NHS employees carry essential equipment, patient records or controlled drugs in their cars. The order is quite specific in stating that only certain NHS staff are exempt in the course of their duties.

Obviously, certain cohorts of staff are renowned for carrying patient records in the boot of their cars but this hospital, which was praised during It is recent Commission for Health Improvement review (good news is no news judging by the coverage) for its good progress with Caldicott, is actively seeking to minimise the transportation of confidential records in this way. Ours is a dual-site trust with central London outpatient facilities.

The congestion order will have serious implications in terms of administration for all London hospitals, which will be required to certificate patients who are exempt and reimburse charges to cohorts of patients and staff, plus apply for exemption certificates to the Greater London Authority to seek reimbursement. There is one ray of light - further potential modification this autumn.

Stephanie Williamson Royal National Orthopaedic Hospital London W1