Could it be an ill wind that is keeping the private finance initiative and clinical services' kite flying? ('Nothing' is ruled out as PFI-style fast-track units are pondered', news, pages 4-5, 1 March).

The forecast - according to your news story - is certainly bright, with the private sector quickly 'challenging existing demarcation lines' and fast-track treatment centres run at '80 per cent of the cost and 200 times better'.

Unfortunately, the Royal College of Nursing continues to receive reports from nurses of adverse conditions in many PFI sites. Barriers to teamworking, increased workloads and pressure on staffing budgets do not contribute to a climate that is conducive to high-quality patient care. The RCN believes that a robust evaluation of the effects of current PFI projects on the quality of patient care, benchmarked against public sector comparators, should inform whether or not the scope of PFI is extended. As with their own practice, nurses would favour an evidence-based approach rather than a finger in the wind.

Howard Catton Policy analyst RCN policy unit