Sir – John Jackson, the county’s director of social and community services, told a public meeting in Oxford Town Hall on January 7 that the county council is proud of the existing pooled budget arrangement for learning disability services.

This was agreed by the chief executives of the county, the Primary Care Trust and the hospital trust ten years ago. It still offers savings and good quality care. The pooled budget was designed by senior staff in close discussion with users, carers and clinicians. There were no extra costs (apart from a very small amount for legal advice). This common sense approach of sharing risk across all the organisations responsible for the same population should now be extended to the whole of health and welfare, prevention and treatment. Because all risks would be shared, everyone involved would have an incentive to make the whole system work within budget.

And senior staff in the existing hospitals, clinics, surgeries and community services would be round the table, there would be less chance of for-profit, corporate, health-care providers controlling more of the NHS and social services provision. In contrast, the Oxfordshire Clinical Commissioning Group of GPs (CCG), who organised the public meeting, are planning to hire COBIC (a for-profit company selling an approach to commissioning services). COBIC proposals for maternity, mental health and services for the frail elderly would be likely to lead to more fragmentation and privatisation, with a loss of services and more likelihood of patients being asked to pay for treatment or do without. Pooling resources and sharing risks takes strong leadership. Have our local leaders got what it takes?

Joan Stewart, Liz Peretz, Bill MacKeith

Oxfordshire Keep Our NHS Public, Oxford