Few would disagree that consultation is generally a good idea, and this must be particularly so when you have a lot of NHS money and are not quite sure what to do with it ('Over to you', news focus, pages 11-12, 4 May). Those who disagree are likely to be described as cynics, or worse, but here goes.

How much is all this consultation going to cost and how much distraction will there be? Those actually immersed in clinical work are probably too busy trying to keep afloat, and have been pleading for what they needed for many years without response.And so has the public. No doubt health economists will have a field day, and so will senior managers wishing to curry favour with their political masters.

As is well known, the results of any consultation are largely predetermined by the constraints applied, and health secretary Alan Milburn has done this in abundance.While aspiring to a health service that emulates the quality of our European neighbours, he rules out the possibility of a mixed-economy funding that our continental cousins have evidently found successful.

Surely one does not need widespread consultations to realise that the NHS cannot possibly provide everything that is demanded for everybody all the time, no matter how much money is poured into it. The only hope is to provide what is clearly effective, delivered efficiently and with reasonable convenience. Everything else should be delivered privately to those prepared to pay for it. There is no other sensible or civilised solution.

David L Crosby Late chair Cardiff Community trust