Sir - I note in The Oxford Times that there is a serious threat to the future of the Nuffield Orthopedic Centre in Oxford.

This is a wonderful hospital that is staffed by some of the finest specialists in the world.

How on earth could consideration be given to incorporate the NOC's services into a larger NHS Trust or independent organisation.

Big is not necessary better in my experience it is usually worse, empire builders often appear, more management staff etc, and the real people have to tolerate meetings etc, that go on and on, and changes for the sake of change, the thought of this is absolutely ridiculous.

D. Walker (Mr) and E. Walker (Mrs), Oxford