To echo the letter in last week's Journal from Cllrs. Judy Pearce and David, McGrath, the NHS proposal to "collapse" the existing Primary Care Trust structure into larger, and thus less local and immediate, organisations is not welcomed.

The South Worcestershire Primary Care Trust (SWPCT), albeit labouring under a financial deficit which was largely inherited, has served local people well and there is generally felt to have been some improvement in the delivery of health care. The accessibility of the officers has been appreciated and their detailed knowledge of local resources and needs has been valuable in addressing issues of concern. Clearly this will be lost in larger and more remote PCT's. It is regretted that this is virtually the only proposal offered in the consultation papers.

The SWPCT has been in existence for barely 4 years and is still wrestling with practical and financial problems inherited from previous incarnations of NHS bodies, themselves also fairly short-lived. There is a probability that, given time, they would be capable of meeting these challenges - a new body will have these problems, plus all those from the other, equally challenged areas, to face. Why should anyone suppose that, by making the issues more complex and the cumulative deficits greater, they will become easier to resolve?

It is particularly surprising that this is being proposed in the light of Central Government announcements on January 31 that there is to be a move back towards more local provision of medical care involving the Community Hospitals and General Practitioners.

The consultation document assumes that the plan will result in more efficient and cost-saving delivery of health-care. There is no supporting evidence presented, and almost certainly there will be a significant cost to achieve any downsizing arising from redundancy payments and cancellation of leases of premises. If such actions are not taken, presumably aiming for longer-term savings, what is the fiscal benefit of the proposals?

There is, similarly, an assumption that these proposals will result in improved health care. Again, no real evidence is put forward about how this will be achieved and it is likely that the confusion and disturbance - not to mention the impact on staff morale, will have the reverse effect, particularly in the short term. So, just when we had learned to live with, if not to love, the SWPCT it seems we are to lose it. For all its troubles it has done its best to improve its services and its financial position. It has, on the whole, carried out genuine consultation about significant plans (unlike the present exercise, where it is clear decisions have already been made). More importantly, the SWPCT has listened and responded to people's concerns where it could.

If it is to disappear, it will leave behind at least one fine legacy, the new Pershore Hospital that is currently being built, a unique partnership between Wychavon District Council that is building it, the NHS that will lease it and run it, and the Pershore Cottage Hospital League of Friends that will help to equip it.

Michael Amies, Bridge Street, Pershore, Worcestershire.