Sir - The benefits documented by the Royal College of Surgeons, and supported by a recent president of the Royal College of Physicians must be accepted as the best possible advice.

Unfortunately, earlier and equally well-informed advice that a complete database of medical data should not be a priority was ignored. The circumstances under which an eight, later £12bn pound contract was negotiated with an American company is not explicit, but there seems doubt as to whether appropriate expertise was either available or consulted. Who signed what? Some, surely could be be reclaimed or at least admitted and realocated to the NHS.

The need to upgrade advanced centres admitting accidents and their associated ambulance services should not be funded by the closure, or excessive downgrading, of smaller centres and still less of entire hospitals.

John Edwards, Retired consultant physician, Oxford