I took great exception to Dr Lister's assertion in your letters page (Tuesday June 3) that waiting list statistics have been manipulated.

Although I notice he was careful not to say specifically that we manipulated figures here at the Great Western, many people will have inferred that from his letter and I must put the record straight.

Our staff have been working extremely hard for years now to drive down waits for patients at a time when the demands on our service are unprecedented. We have challenging Government targets to meet in terms of waiting times against a backdrop of increased emergencies and a growing population.

The demands on our services have never been higher, yet year on year we are reducing the length of time people have to wait.

We achieve this through innovation, improvements in efficiency and sheer hard work. We do not do this in isolation we work closely with our partners in the Primary Care Trust who fund our services and with other healthcare providers in the area.

To suggest that we simply massage figures to produce more favourable statistics is not only wrong, it negates the effort and dedication of NHS staff to make genuine improvements to healthcare in this area and quite frankly I find that insulting.

Had Dr Lister read your recent coverage of our achievements in reducing waiting times for cataract operations more thoroughly he would have learned that the reason we had a waiting time of just three to four weeks (shorter than the private sector) is that due to extra funding from Swindon PCT our consultant ophthalmic surgeon, Thamir Yasen, has been operating on patients at Westbury Community Hospital at weekends which means he has been performing around 80 operations a week.

This is not private work it is an example of the NHS working hard to improve services.

As for Dr Lister's comment about the size of the Great Western, I will repeat, yet again, that the planning for the new hospital was in 1995. In 2000 the Department of Health launched its national plan with a whole range of challenging targets around waiting times and activity.

To meet those targets we need a larger hospital with more beds hence the new 36-bedded ward and 26 bedded interim ward, both of which will open later this year and the new Diagnosis and Treatment Centre (DTC) which will open in 2005.

The difference between the DTC and the hospital is that the DTC will cater predominantly for elective surgery operations that have been booked. The Great Western main building will then be able to concentrate on emergencies.

I fail to see why Dr Lister describes our expansion and development of services as "the unhappy truth". Surely a bigger hospital with more facilities is exactly what he and we all want.

I would also like to know on what evidence he has based his assertion that the expanded hospital will also be too small.

I find it very sad that Dr Lister can only find fault in our new hospital when there are so many positives.

The "happy truth" is that we are performing more and more operations, steadily driving down waiting times year on year and caring for more people in the most modern and one of the most technologically advanced hospitals in the country.

It is equally sad that despite our staff working extremely hard, often beyond the call of duty, to provide high quality health care for the people of this area, there are still some people for whom those efforts will never be good enough.

It is always open season on the NHS in general and the Great Western in particular, and while most of the people we care for are very supportive and complimentary about the care we provide it seems it is always the strident dissenters who attract the most attention in the media which is a great pity because they are far from representative of the majority.

Lyn Hill-Tout

Chief Executive

Swindon and Marlborough NHS Trust