I WOULD like to expand on the letter from Dr Booth in the Shuttle of February 22, concerning the inevitability of changes in hospital services due to the reduction in the number of hours that junior doctors are allowed to work.

This problem is compounded by the severe shortage of all types of staff who work in the health sector and the ongoing difficulties of recruitment at the rates of pay on offer.

Your chances of survival from any condition depend on the quality of care that you receive, not the set of buildings you arrive at.

At present there are not enough health professionals across the country to provide comprehensive health care at numerous small sites.

Despite the comments of Mr Wormald (Shuttle, March 1) this situation is unlikely to be rectified as it would require a substantial increase in taxation.

In this situation, centralisation of services is inevitable (even though undesirable) in order to use the available staff most efficiently and monitor the quality of the clinical work carried out.

Arguments about whether certain areas have the population to warrant full hospital services are irrelevant if the county does not have the staff to safely provide them.

Ask yourself this - would you rather be on a ward where there are sufficient trained staff to allow for adequate breaks, or would you rather take the risk that the only trained nurse is dealing with an emergency and the cleaner has been commandeered to check your pulse?

MISS E WATKINS

Woodfield Crescent

Kidderminster