While Ken Kirk may have concerns about "big business" being allowed to run GPs' surgeries (Letters, March 20), he should not close his mind to the benefits they could bring to patients or to the limitations of present arrangements.

What is wrong with businesses aiming to make profits? Any sensible business realises that sustainable profits come from consistently providing services that customers value and so will focus on this as its main objective in ways rarely found in the public sector.

Profits also help stimulate innovation and investment. Is protecting receptionists' and practice nurses' membership of a generous pension scheme, guaranteed by the taxpayer, really regarded as a higher priority than striving for better patient satisfaction and value for money, as he implies?

Our state healthcare system is unusual in the developed world in making so little use of what the independent sector can offer. It is up to the local primary care trust (PCT) to explore partnership contracts with suitable businesses.

Ones that place the maximum focus on patient care combined with good value for money and as a result unleash benefits that have been in short supply to date.

Of course, businesses that fail to deliver on their contractual promises should be firmly dealt with and so should existing GPs' practices who fall short of the high standards that taxpayers are entitled to expect. Whether our PCT has the courage and skills to do this effectively remains to be seen.

  • Peter Reeves, St Keyna Avenue, Hove