YOUR correspondent A. Lubin asks, in a letter published on November 7, what the Community Health Council thinks of the use of private hospitals by the NHS.

We have not debated the merits of the idea per se, but since our first concern is the good of patients, we have during the last year monitored the use made by PMH of two private-sector providers (the Ridgeway Hospital and the Bath Clinic). In both cases our visiting teams found that the patients had received satisfactory treatment and had been treated earlier than they would have been by NHS resources. You may like to see our conclusions from this exercise.

1. Public/private initiatives should be reserved for demonstrably exceptional case of need, eg unreasonably long waiting lists.

2. All public/private initiatives must be public knowledge to ensure that patients' best interests are safeguarded.

3. Cases selected for treatment in private hospitals should be those that are clinically straightforward to minimise risk of complications.

4. Patients must be allowed sufficient time to make a reasoned and informed choice concerning their treatment options. In practice, this means writing to inform patients of the initiative and allowing at least a week for a response.

In the spirit of the second of these points, we have asked the PMH management to tell us in advance of any future schemes of this sort.

JOHN WALSH

Chair, Swindon and District Community Health Council

Temple Street

Swindon