Dr Maggie Harding (letters, 12 August) does a disservice to women with ovarian cancer. She draws attention to the June Effective Health Care Bulletin on the management of gynaecological cancers, which recommends that Paclitaxel and Carboplatin should be the treatment of choice for this disease. Yet she congratulates health authorities for not funding the same treatment. What message are patients to take from this?

When ICON 3 was presented at the American Society of Clinical Oncology, Dr Bill Mcguire presented an analysis of the data for women with any residual disease. This gave an odds ration in favour of Paclitaxel and platinum of 0.82 (p=0.03, CI 0.69-0.98). It is this analysis to which Dr Thomas referred. Public health doctors do not have a monopoly on reviewing evidence - and unlike oncologists they don't have to deliver the care directly to women based on that evidence. It is naive to assume that Dr Thomas and the other doctors who signed the consensus statement last year are motivated by anything other than the welfare of their patients.

CancerBACUP did not find that 80 per cent of HAs did not fund this treatment.

We found that less than 20 per cent had formal mechanisms in place for funding this (or any other) new cancer chemotherapy treatment; in the others, decisions were taken on an individual basis. So, not only did women have to face the diagnosis of ovarian cancer, they had to fight to get the treatment their doctor wanted to prescribe.

Postcode prescribing is alive and well in the UK - aided and abetted by public health doctors.

Jean Mossman

Chief executive