Why trust PCTs?

Why the professional bodies are so keen for us to put our faith in PCTs I cannot imagine, now NHS work may be put out to the lowest tender (News, July 29).

Dentists turned their backs on the NHS years ago, only a surfeit of optometrists (FODO's fault) prevents us from doing so. Perhaps those of the 'Big Four' not doing so well might even pitch for these contracts, but no doubt it is futile to expect a united front in refusing to accept lower payments.

In what is a blatant exercise to cut costs, the DoH is trotting out the usual hypocrisy about suiting local needs, whereas patients will be far worse off. At present, a more comprehensive eye exam than the fee warrants is carried out, using expensive equipment the NHS does not fund, at the patient's place of choice. Patients can select hospitals of their choice, but not opticians. NHS surgery is successfully contracted out - even to France - but elderly NHS patients will be disallowed from attending their local optician.

I would imagine anybody tendering for loss-making work would have to turn around a large volume, supply a restricted range of 'NHS' frames and rely on 'add-on' charges to survive. Withdrawal of universal acceptance of NHS vouchers removes the once-trumpeted freedom of choice to shop around. Presumably, those NHS-eligible patients unwilling to attend the new and wishing to consult their usual optometrist will have to go private - giving the PCTs the savings they seek.

Sitting in their Whitehall bunkers, officials may not be aware that most people only want to consult their usual optometrist who has established a good rapport with GPs, hospitals and so on and understands their needs. He/she also possesses their records, established over the years, kept to College guidelines and even inspected by PCT officers. Will these be available to employed optometrists working for lay persons providing NHS services at the lowest quote?

What has happened to the 'best practice' we heard so much about?
Mike Cooper, Enfield