Published: 10/10/2002, Volume II2, No.5826 Page 23

I was not surprised to read your article on the problem of agency nurses in the South West ('Holiday package', news focus, ` 19 September).

Hospitals and agencies have traditionally been very adversarial, and as such have failed to work together to create a real solution to the problem of staff retention and recruitment.

This is the root cause of the problem. Agencies address the problem through increased wages and hospitals address it through flexible working. Neither solves the problem.

In the long run, the increase in wages given by agencies spirals out of control, with different agencies competing to provide more money for the 'cash strapped' nurses.

Hospitals simply cannot and do not compete.

The NHS sees legislation and new 'approaches' as the answer; agencies see them as overly complicated and designed to increase costs and alienate.

Implementing frameworks within which agencies meet very specific requirements is not the answer.

This simply reduces the number of players in the market and, as we all know, when the numbers of suppliers are small they become even more powerful. The answer, in short, is a partnership approach.

Hospitals have a tremendous amount of purchasing power and should be able to engage in constructive dialogue with their suppliers to reach a commercially sensible agreement on how much they are charged, for what and over what time frame.

But this needs to be done at a local level where relationships and trust can be built upon.

Christopher Carter Managing director Link 24 7 Sevenoaks Kent