Published: 29/07/2004, Volume II4, No. 5916 Page 21

Readers scanning the introduction to the specialised services piece written by my chair, Baroness Hayman (Speak Out, page 21, 15 July), would have received a highly misleading impression.

Payment by results was cited not as a policy likely to help but as an example of policy development ignoring specialised services until perilously late in the day.

Similarly, payment by results is struggling to accommodate the complexity of specialised services precisely because it was designed to drive efficiency in more homogeneous areas of treatment.

The Specialised Healthcare Alliance is delighted that the government is listening to its concerns.Well-wrought policies are essential in delivering equality and excellence in the NHS and this applies with particular force to the vulnerable patients affected by specialised services.

John Murray Specialised Healthcare Alliance