IWOULD like to thank and congratulate both the Hospital and Primary Care Trusts in Bolton, especially Mr John Brunt, for their vision and commitment to the services for older people by retaining and augmenting the use of Hulton Hospital.

Hulton has been a "gem" of little hospitals in Bolton and, as someone inextricably linked with it for nearly three decades, I express my personal delight. It has always been an intermediate care facility for frail older patients.

In the mid 80s, the then Health Authority had wanted it to become a private nursing home which was vigorously opposed and the proposal subsequently withdrawn.

In the mid 90s, the Bolton Hospital Trust, had made an effort to establish an educational centre within the NHS, based at Hulton to excel and promote knowledge among all health care professionals on the care of older people. Outside "bureaucracy" and "intransigence" however thwarted that endeavour.

The dedicated staff there had been living in uncertainty ever since but this new decision will stabilise that.

A word of caution however.

Caring for the old who are sick, dependent, frail and vulnerable is not easy; it warrants more manpower, nurses, therapists, doctors dedicated to this job and properly trained in this field. The service needs priority and more investment. Unless patients receive full treatment and rehabilitation, their recovery will be impaired and they won't be fit to be discharged from Hulton; patients can't be transferred from the Royal Bolton and that hospital will remain clogged up so the Authorities, having demonstrated their commitment must do more.

One dimension of quality, i.e. longer-term clinical outcome, should not be implicitly sacrificed for short-term convenience, e.g. acute beds.

Arup K Banerjee OBE FRCP

President, Bolton over50s Fed

Ret'd Consultant and Medical Dir

Royal Bolton & Hulton Hospitals