LETTER: POSSIBLE BENEFITS OF VIRGINIA BOTTOMLEY'S HEALTH SHAKE- UP

From Mr Philip Hunt

Sir: Your leading article "Time to lead, Mrs Bottomley" (6 April) rightly points out that health services rationalisation in the capital has been talked about for a long time. For the sake of the millions who live, work and visit the city it is essential that we get the equation right. It is also right to recognise Virginia Bottomley's role in tackling these very hard issues.

Change is inescapable. What is happening in London is being reflected in many places around the country. Many more procedures are being provided in speciality centres where expertise and technical support are on tap and where clinical outcomes have been shown to be better. And the emerging pre-eminent role of primary care is just as important in ensuring that more treatment is provided closer to home and in the community.

Changing the role of the familiar district general hospital is bound to cause public anxiety and it remains a major challenge to persuade the public of the benefits. But it is a challenge worth meeting if Londoners are to get a top quality service.

Yours faithfully,

PHILIP HUNT

Director

National Association of

Health Authorities and Trusts

Birmingham

6 April