letters

Published: 27/02/2003, Volume II3, No. 5844 Page 24

The news story 'Rush job on [diagnostic and treatment centres] could put local needs at risk' (pages 4-5, 13 February) reported on a survey of various chief executives carried out by the NHS Confederation. I am intrigued that its conclusion is a fear of a one-size-fits-all solution.

First, 11 of the procurements are led locally and sponsored by the relevant primary care trusts and strategic health authorities. Second, the central procurement team at the Department of Health has stressed repeatedly the need for the independent sector to be very flexible and prepared to adapt their offerings to each local situation.

Third, the independent bid I am leading places an emphasis on integration with the local health community and on care pathways in particular. I imagine that most others will too.

The comment that 'the recent capacity planning process on which DTC provision will be based failed to adequately identify capacity gaps', despite thousands of working hours over at least a year, demonstrates the futility of basing service provision on super-detailed knowledge of demand. I have spoken to many Americans in the last year who are astonished that we would allow even a three-month wait for inpatient care. There is a clear need for more elective capacity (as well as other sorts of growth in activity) and it is to the government's credit that they have at last established a method that might achieve it.

Mark Smith Mercury Health