Published: 20/03/2003, Volume II3, No. 5847 Page 22

It is clear that many older people do not like mixed-sex wards (cover feature, pages 26-29, 20 Febuary), or even the sleight of hand represented by the single-sex bay.

The national service framework for older people specifies that stroke patients will be in a specialist unit within 24 hours.

We operate a large stroke service, with two admissions a day on average. On 95 per cent of days, taking account of a chance variation in admission numbers, we need five empty beds. On 46 per cent of days, none or one will be used - not good news when bed managers snap up every available bed for emergency general admissions and ride roughshod over ring-fences. To segregate sexes, we would need seven empty beds a day.

We compromise the quality of clinical care by segregating - we also lose continuity. I no longer look after male rehabilitation patients who I treated when admitted as emergencies because our wards are segregated.

Many more features of our hospital environment compromise dignity, especially noise at night and lack of provision for behaviourally disturbed patients.

Personally, I would have no objection whatsoever to being on a mixed-sex ward. Is this a generational thing?

Dr Rowan Harwood Consultant geriatrican Queen's Medical Centre Nottingham