You report on a possible deceleration in NHS commissioning of private sector healthcare provision ('Private slow-down expected as service prepares for Brown'). It may seem odd to hear a private sector organisation saying this, but if such a phenomenon occurs, it will not necessarily be a bad thing. This is provided that it does not undermine the idea of efficiency through competition..

You report on a possible deceleration in NHS commissioning of private sector healthcare provision ('Private slow-down expected as service prepares for Brown'). It may seem odd to hear a private sector organisation saying this, but if such a phenomenon occurs, it will not necessarily be a bad thing. This is provided that it does not undermine the idea of efficiency through competition..

Competition for service provision in the NHS does not have to be a private versus public affair. In fact, competition between NHS providers can be perfectly effective in driving efficiency.

However, we.cannot forget that access to the latest equipment and technology can have a.disproportionate effect on efficiency. Several leading trusts have now changed their management processes to more closely reflect the private sector. By using a full range of financing techniques to ensure their technology base is up to date, trusts can achieve the most efficient healthcare provision possible while having a competitive advantage over private and public sector rivals.

An efficient and effective public sector is the most desirable outcome from the taxpayer's perspective. As long as this outcome is achieved, there should be no particular dogma about the level to which the private sector needs to be involved. However, any backpedalling on efficiency gains so far should be viewed with extreme caution and concern.

Rod Tonna-Barthet is director of Siemens Financial Services.