SIR – It was my intention to write a simple letter of appreciation for the surgery and subsequent excellent nursing care I have recently received at QE2 but I have been overtaken by Grant Shapps reply to my previous letter in which I complained of his

SIR - It was my intention to write a simple letter of appreciation for the surgery and subsequent excellent nursing care I have recently received at QE2 but I have been overtaken by Grant Shapps' reply to my previous letter in which I complained of his negative campaigning.

My recent treatment is but one of many reasons why I have a fondness for the place and loyalty to it.

Two of my grandchildren were born there - the first when her parents lived in Stevenage when the Lister had no maternity unit so they had to negotiate the A1(M) south!; two of my children had appendicetomies there and one a tonsillectomy; and last, but not least, I spent a large part of my working career (20 years) working at the QE2.

It is this long personal experience that has led me to keep myself well informed about recent developments in the local health service and it is therefore only on this subject that I feel confident to challenge our admittedly popular MP.

I am not, however, quite as politically na�ve as he assumes and I can see that it would be possible that decisions about which of the three hospital sites (Hatfield, QE2 or the Lister) should be chosen for development could have been influenced by central government for political as well as practical considerations.

What Grant misses, however, as a result of wearing his political spectacles, is the underlying reasons for the re-configuration of hospital services and the need to concentrate specialised acute services in one centre for a wider area with a bigger total population.

Senior consultants in the East and North Herts NHS Trust have already explained that, in order to maximise the benefit of recent rapid advances in medical and surgical practice it is necessary to centralise acute services in larger hospitals serving a population of 500,000 or more.

In addition to the need for special equipment, there has to be a 'critical mass' of patients with the rarer conditions for staff in a centre of excellence to gain sufficient specialised skills.

Papers available on the NHS website explain this in more detail.

[Mrs Saunders goes into more detail, see our online letters section; www.whtimes24.co.uk - editor]

The other major change in health policy has again been driven by advances in medical and surgical practice rather than by political considerations - the shift from prolonged hospital care to care at home.

A case in point was my own recent surgery, that not long ago would have entailed a hospital stay of 10 days or more and a prolonged period of inactivity. Advances in surgery and anaesthetics enabled me to be in hospital and out again in three days and, already, three weeks later, I am almost back to normal.

At the same time, a dear friend and relative of mine living in a neighbouring authority who had been diagnosed with bone cancer 18 months earlier, was able to fulfil her wish to remain in her own home (although living alone) until three days before her death in a hospice, so excellent were the domiciliary services both from the NHS and from her (Conservative) local authority.

I was fortunate in requiring no help from social services but I understand from neighbours and friends that such excellent care by social services is sometimes lacking in Hertfordshire so perhaps Grant could turn his attention to persuading his friends in County Hall to ensure that our domiciliary services are improved to an equally high standard.

The shift from hospital to home care has, of course, placed additional responsibility upon the GP surgeries.

In the 2007/8 survey of patient satisfaction with GP services, while Welwyn Hatfield residents showed a generally high level of satisfaction their chief complaint was of the difficulty they experienced in obtaining appointments, with blocked phone lines exacerbating the problem. It is this deficit that Spring House is designed to address and is now addressing without undermining the patient's relationship with the GP with whom they are registered.

I repeat my original plea for a less negative and more informed attitude towards the development plans for the QE2.

Betty Saunders,

Birchall Wood, WGC.