I go further than Jo Manley (letters, page 22, 26 October). I see much of the conference industry as a scam.

There rarely seems to be a real target market for these expensive events. In my (rare) experience, few of the contributions seem to have been written explicitly on the advertised theme.

I would like to see the whole industry subjected to an Audit Commission value-for-money review. I would like to know the final destination of all expenditure. How much to expensive locations and food?

How much on advertising? How much on fees to speakers (especially to those loosely associated with the government), and whether these go to employers or individuals?

What is the cost of participants' time, travel and of the associated administration?

'Training' has been the flavour of many successive months, but commitment to training is measured superficially by (claimed) attendance rather than by any real evaluation.

Martyn Smith West Birmingham CHC