April 1 was an appropriate date for publication of Andrew O Robertson's letter as it fails to allay fears about the future of St Margaret's Hospice in Clydebank. I recently met Mr Robertson, chairman of NHS Greater Glasgow and Clyde. I asked that the health board reinstate the five-year contract to provide care to the frail elderly which had been agreed between the hospice and the board and which was, without explanation, removed by the board. The hospice has never had a contract and this leaves us vulnerable to changing board policies, in particular the private funding of the replacement hospital at Blawarthill where our beds are to go.

Mr Robertson's response to my request to give the hospice security of provision was to write to me a "personal" letter copied to various parties. This was addressed not to the hospice but to a place of business I have not occupied for nearly two years. It was transmitted by fax at 5.05pm on a Friday. Instead of offering reassurance to allay my or anyone else's fears, he advised that referrals to the hospice for care of the frail elderly would cease from April 1, 2009. The only options open to the hospice were to provide Social Work Department-funded care home beds or health board-funded beds for the care of people with mental illness. Neither provision is consistent with the work Scotland's oldest and largest hospice has provided for some 58 years. There has been no attempt by the health board to provide a solution maintaining the hospice care we provide, as it has been requested to do by the Petitions Committee of the Scottish Parliament, members of all political parties and the 90,000 people who have signed a petition of support.

The hospice needs to raise £30,000 a week. A formula providing half of the approved funding for care of patients in the palliative care ward falls well short of requirements. The patients we look after in the frail elderly ward deserve hospice care. There should be full cost recovery from the health board for these patients. To withdraw that funding removes two-thirds of the monies we receive from the health board. Hospice care at St Margaret's would cease if we could not raise an additional £40,000 per week. More importantly, our patients would lose the care we provide when they most need it.

The health board must recognise it needs to change policy or risk losing a beacon of excellent care. The people who attended last Thursday's meeting and all our supporters are in no doubt what the effect of misguided action by the health board will be.

Professor Leo Martin, Chairman, St Margaret of Scotland Hospice, East Barns Street, Clydebank.

Scrutiny of the NHS
Douglas Sinclair of the Scottish Consumer Council makes an interesting contribution to the debate on scrutiny of NHS services (The Herald, March 26). It is, however, important to recognise NHS Scotland is subject to independent scrutiny by Audit Scotland, which scrutinises regularly NHS finances and reviews the performance of services. Moreover, although NHS Quality Improvement Scotland is a special health board, it is independent in its assessments of the quality of clinical services and of the care and treatment provided to patients, and in the recommendations it makes to the government and the NHS. This is reinforced by the inclusion of patients and members of the public (alongside clinical experts) as full members of its review teams.

NHS QIS does not hesitate to highlight where NHS services fall short, and it publishes all its findings. This was exemplified by our report on chronic pain covered in The Herald last week. Independence depends upon more than formal structures and procedures. The track record of scrutiny in the NHS stands comparison with the rest of the public sector.

Sir Graham Teasdale, Chairman, NHS Quality Improvement Scotland, 50 West Nile Street, Glasgow.