Your article "Elderly care homes face cash crisis" (Evening Advertiser, November 13) fails to indicate the near absolute dependence of both the acute hospital sector of the NHS (i.e. PMH in Swindon) and the mental health sector of the NHS on private sector residential and nursing homes.

According to the Department of Health, there has been a 40 per cent decrease in the number of acute general hospital beds in the UK in the past 15 years.

Meanwhile the population has continued to grow, particularly the proportion of over 65s, who are the major users of NHS hospital facilities. If the care homes were to close the effect on NHS services would be catastrophic.

Bed blocking would become a major problem and waiting times for hospitals would increase at an alarming rate.

These homes provide a service at a fraction of what it would cost the NHS. However, unlike the NHS, private care home owners have provided all the capital costs of the homes themselves.

Nobody seriously imagines that the likes of Tesco or Woolworth are not in business to make a profit, and exactly the same is true of residential and nursing home owners. If their homes are unprofitable they go out of business.

With the changes imposed by the Care Standards Act, as well as European directives, care home owners are asking themselves whether staying in business is worthwhile.

These factors, combined with property prices and the indifferent fees paid by the NHS and Local Authorities, provide very real incentives for home owners to sell up.

The problem that faces Swindon Council Social Services is where to find the money for the kind of fee increases required to rectify the present situation.

The director of Housing and Social Services has suggested a four per cent increase as an absolute minimum, in order to keep within her budget constraints, but an enquiry has revealed that it will require a fee increase of the order of 20 per cent to reverse current trends and to encourage the establishment of new homes, which are desperately needed.

But an increase of this size would be the equivalent of a rate increase of something like 7p in the pound.

Given the pressures on the council's budget, notably from the education sector, then a substantial rate increase would seem to be inevitable.

What should be appreciated is that the need for such rate increases stems principally from the failure of central government to fund national services, such as the NHS, adequately.

(Dr) C O Lister

Whitworth Road

Swindon