SIR - The proposed changes to the National Health Service are worrying, especially centralising the A&E departments.

My first reaction is why change? The service provided by our paramedics is first class. Their response time is one of the best in the country.

So why change? The reason given is financial. Why not sort out where the cash is being misused by mismanagement? Hands off the work force.

MICHAEL ASHBY, West Malvern.