SIR – As someone involved in a local charity (and as a vocal critic of Hertfordshire s health service proposals) I am on the latter s mailing list and have just received the latest summary of public feedback . I commented in an earlier letter that consu

SIR - As someone involved in a local charity (and as a vocal critic of Hertfordshire's health service proposals) I am on the latter's mailing list and have just received the latest 'summary of public feedback'.

I commented in an earlier letter that 'consultation' really meant agreeing to a foregone conclusion and the compilers of the summary do not perhaps realise how revealing their words now are.

The letter needs to be read in its entirety to get the full flavour, but, after acknowledging all the caveats and objections included in '6,000 questionnaires, 300 written submissions and 60,000 petition signatures' the pre-consultation analysis (my italics) - choosing the Lister - was upheld. I quote: 'The information that came forward during consultation did not materially alter this conclusion'.

So much for democracy!

But let's suppose for the sake of argument that the experts think they've got it right (those same experts who wasted £12 billion on a flawed IT system and chucked our money about on rearranging management systems with the recklessness of a drunken sailor).

The devil is always in the details and the information is woefully short on them.

We are to lose accident and emergency and maternity care and get instead an 'urgent care centre'.

What is that, you ask?

If I read it right, it will be another A&E department; but not quite. What that means, I cannot distinguish.

The best outcome or even survival for severely injured patients (who will go to A&E at Lister) can depend crucially on getting them stabilised in the first 'golden hour'.

If 40 minutes of that hour is taken up by travel to the hospital, we are going to see many unnecessary tragedies.

The problem is acknowledged, but no solution offered. (Ditto for public transport and car parking - and there's a devilish detail!)

You live in Stevenage? So you get there in 10 minutes and wait six hours on a trolley because of all these unnecessary WGC interlopers.....

Although the rhetoric has always been about 'improving' patient care (by closing services!), here is another revealing quotation: 'A financial appraisal of potential consultation options identified that consolidation at the Lister site would produce a larger financial surplus than consolidation at the QE2'.

Economies can always be made by closures; that's an easy option, but can it be any surprise that services will then be worse?

There has to be a better way to fund and manage the NHS and that's a national problem.

I'm sure everyone involved has done their damnedest to balance the difficulties, but you can't solve problems pragmatically within a dogmatic framework.

It is, and always has been, about money.

There's plenty of it; it's simply being wasted.

Try harder, guys.

Jon Westoby,

Via email.