SEVERAL recent letters have referred to threats to cease providing children's services at Fairfield Hospital.

A programme has begun across Greater Manchester to improve all NHS services to children, and to improve access to these services. This involves every single hospital Trust and all Primary Care Trusts, which arrange GP and community-based NHS services.

Over the last three decades, children have begun facing different health problems. The most common contact between a child and the NHS is via a GP, a health visitor or the school nurse. Many childhood illnesses are best treated at home, or in community settings, avoiding unnecessary trips to hospital, or avoidable admissions to hospital.

In Bury, as in other places, we want to retain and improve local access to emergency, outpatient and community services and redesign hospital services to ensure every child receives the best care.

There is widespread acknowledgement among professionals about the urgent need for a fresh look at how we can care for children. We need to take action now for a wide range of reasons, including:

The need to focus on the issues which affect children;

National guidelines recommending stronger working relationships between the NHS and social care, education and voluntary sectors;

A change in children's health issues: medical advances have dramatically cut deaths from conditions such as polio and whooping cough, but other conditions are increasing in children, including asthma, obesity, mental and emotional problems;

A decline in the amount of time which children need to spend in hospitals. The vast majority now stay a single night or less.

The need to ensure that services for treating children are safe and reflect the best practice available;

The need to ensure that staff are skilled in treating children. We also need to be able to attract and keep those staff, against competition from across the country.

Correspondents also referred to public consultation, and we are absolutely committed to that. Indeed we have to go further. We cannot simply conjure up a blueprint and then ask for views.

We need to involve residents, NHS staff and other professionals in the process of actually developing potential options, and considering all the pros and cons. After all, it is the people who use the services and the people who provide them who know best what is needed, and what can be delivered.

We then need to get wider feedback on those options, allowing us to make specific recommendations. In line with the other parts of Greater Manchester, we need to complete this work by the summer.

This will not be a simple process. We have to take people beyond the headlines to explain the complex issues involved around successful provision of NHS services. And we have to get it right, to safeguard the future of our services for children.

We need to make sure that the investment in the NHS is put to best use locally, funding both the community services and the hospital services which we need to help all children.

This is is absolutely not a cost-cutting exercise. If anything, it is likely to cost the NHS more. But we need the public's help and assistance to enable us to develop a sustainable NHS which will meet the requirements of Bury's children in the decades to come.

We are currently working with other agencies including the local authority. We will be holding a series of open events to help obtain a wider cross-section of view. These will be well publicised, and we hope that as many people as possible will attend them, so that we have the best-possible reflection of Bury's views.

EVAN BOUCHER,

chief executive,

Bury Primary Care Trust.

Dr. RUTH JAMESON,

associate medical director,

Women and Children's Division,

Pennine Acute Hospitals Trust.