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In their recent essay (JRSM 2007;100:306-8), Maynard & Ayalew referred to the absence of patient reported outcome measures (PROM). They should have been aware that the Royal College of Surgeons of England, with the London School of Hygiene and Tropical Medicine, carried out a project to establish the feasibility of applying PROM for elective surgical procedures. The final report in June 2007 recommended specific measures that are going to be used as part of an audit we are undertaking with the Department of Health relating to surgical outcomes in Independent Sector Treatment Centres (ISTCs). We expect to publish our preliminary findings in 2010. Far from ignoring this vital area of assessment, we have shown leadership by employing this research tool to resolve preconceived attitudes about care in ISTCs.
Maynard & Ayalew referred also to the NHS subsidizing Royal Colleges by releasing consultants for examination and other duties. It is not the Colleges that benefit by this arrangement, but the NHS and its patients, as those involved in teaching, training and examining are helping to ensure high standards of care in the future. My College's examiners are not paid a fee and I doubt that the population generally would criticize this use of their time. Professor Maynard has a direct interest in this issue as the Chairman of a Foundation Trust and I wonder whether his interest has been declared.
Competing interests None declared.