I AM very happy to answer points raised in Dawn Robinson-Walsh's recent letter about the "Have Your Say" NHS supplement published in the Bury Times.

"Have Your Say" gives people the chance to influence the development of formal options for future NHS services in the Bury area and beyond - both in primary care (community) and in acute care (hospitals).

The nature of the NHS is changing; we can do much more in the community now than, say, 20 years ago. We need to ensure that, where possible, we are moving services closer to the public and helping people avoid unnecessary admissions or visits to hospitals.

We also need to make sure that patients who do need hospital treatment receive the highest quality alternative treatment, making the best use of technology, with the best results.

For some specialties, this certainly implies creating "centres of excellence" but we would always envisage local outpatient services.

Medical treatment in our hospitals is of very high quality, but that's because our clinicians work hard to keep it that way, and we can not be complacent. We need to take account of the national studies making it clear that, for some specialties, frequency of treating patients is essential in ensuring that clinicians keep their skills sharp, and provide the best quality of care.

We also need to make sure that we develop services to make them attractive to staff - both current and prospective. The NHS has a high staff turnover, and the most-skilled staff can pick where they want to work. If you could work for a hospital which met the European Working Time requirements, giving you a sensible working week, or working for one which didn't, then where would you choose? Plans are simply that - they only work if we can attract and retain the staff to provide those services.

As to Fairfield's future, we would certainly point out the investment that's been going in to the hospital. Recently this includes the £1.8 million education centre, the £700,000 pharmacy, £250,000 for the crucial care unit and now an essential services laboratory costing nearly £1 million.

The service development work is taking place at the same time as the children's and maternity review. As everyone in Bury knows, those recommendations are due to be published over the summer, so naturally our document refers to that review. The plans will have to be carefully considered against each other at the time.

The public involvement programme is being led by the area's primary care trusts, including Bury PCT. Bury Times readers who want to get involved, but who missed the "Have Your Say" supplement, can get more copies for free by calling 0161 655 1712 or online at www.hmpct.nhs.uk/haveyoursay . We are asking for responses by March 31. The feedback will be independently analysed by the University of Salford and then fed back into the development process.

This will lead to the development of options for the future of NHS services going to full, formal public consultation, when there will be plenty of opportunity for people to have their say on the specifics.

We'll be explaining what our plans are, how there were developed, and why we think they are the right way forward. By using the "Have Your Say" opportunity, the public can make an early impact on this work.

CHRIS APPLEBY,

chief executive,

Pennine Acute Trust.