Letters

I am glad that Alan Maynard has developed the idea of the incomplete health record (Looking Askance, 12 March) that I have been flagging for the past three years at public meetings, in the Kaizan care group colloquia, letters to the professional press, and numerous conversations with health service managers.

We used to have only an NHS medical record and little else. Now it is not unusual for an individual to have records for the NHS, private GP and hospital, travel clinic, occupational health, over-the-counter dispensing of medicines (many are still NHS reimbursable), and overseas treatments.

None are generally linked. This has obvious implications for patient monitoring, outcome research, adverse drug reaction monitoring, and health economics. It means the NHS may be working from incomplete records. Finding a solution to this could be an excellent project for cross-sectoral co-operation.

Professor Maynard has written a very useful article, and I hope others will respond positively to his views on integrating care.

David St George, Newbury, Berkshire.