Recently you published a letter from a Malvern resident praising the work of staff at the Worcester Royal Hospital in removing a cancer from his oesophagus.

Like your correspondent, I am in recuperation from this operation and would fully endorse his unreserved praise of Worcester Royal Infirmary.

I would like to add that the level of expertise, support and care I received from all at the Avenue Road Surgery and the district nurses who attended me was truly remarkable and for which I am truly grateful.

From reading press comment about the NHS and Worcester Royal Infirmary, my confidence in the level of treatment I would get was severely undermined. No matter how valid the criticisms are, this, coupled with the on going debate about the Malvern's community hospital, must worry any patient who is about to under- go a major operation.

The first point I would like to make is that the NHS and the Worcester Royal Infirmary works extremely well if you have a life threatening condition - it provides a first class service. There is no doubt there are inefficiencies resulting from the hospital being possibly 100 beds too small and having to work at levels of maximum occupancy all the time.

Cancer of the oesophagus is, unfortunately, one of the cancers for which year -on-year the numbers increase. Surgery following a course of chemotherapy is often the only form of treatment. The effect of the surgery has been likened to surviving a major car accident and only those fit enough are allowed to undertake it.

From my own experience, the immediate after-care nursing in intensive care followed by the high-dependence unit and then general surgical ward was as a major factor in a successful outcome as what went on in the operating theatre.

Currently, Worcester Hospital has two surgical teams undertaking similar procedures to the one I had - such is the need.

It has been decided that these operations will no longer be performed in Worcester from April 2006, when they will be moved to Gloucester Hospital.

The second point of this letter is to protest that this must not happen. At a time when the Government is continually preaching the gospel of choice in the NHS, how can this be reconciled with the severely-ill people of Worcestershire now being carted-off to Gloucester to have their operations.

It is an act of extreme irresponsibility to lose the expertise that has been built up over the years at Worcester - not only the surgeons but the specialist after-care that is so important.

I have no doubt this initiative to centre the region's skills in Gloucester is financially based - not on what is best for the patient. I would ask that all the MP's in Worcestershire, irrespective of party politics, work together to prevent this and other reductions by stealth in the level of NHS provision in our county.

John Ford, Avenue Road, Malvern.