Letter: NHS hard times

Sir: I heartily endorse many of the comments by the president of the Royal College of Psychiatrists ("Royal medical colleges `just cosy clubs' ", 2 December) on the need for the medical royal colleges to stand up and be counted on the question of clinical standards.

I have always believed in professional self-regulation, preferably through critical peer review.

The problem is that the colleges have not been consistent in their approach to issues like regular re-validation through peer review and, even if they had a common position, they do not seem to have teeth to take action against consultants who choose to ignore them.

Perhaps the "teeth" need to be given by the General Medical Council, but the coll-eges do have to agree and set the speciality standards first.

A J VALLANCE-OWEN MBA FRCS Ed

Group Medical Director

Bupa, London WC1