SIR, — Once again I find myself reaching for my pen to respond to yet another catastrophic blunder in the provision of care for the disabled, old and infirm. With reference to article about Supporta Care and the people who have been left in bed and uncare

SIR, - Once again I find myself reaching for my pen to respond to yet another catastrophic blunder in the provision of care for the disabled, old and infirm.

With reference to article about Supporta Care and the people who have been left in bed and uncared for (Herts Advertiser, Ma 29). Is it beyond the comprehension of Herts County Council's Adult Care Services that if you continually put out tenders to companies to bid for care package provision and that those packages are won on the basis of cheapest wins, there comes a point that care can no longer be provided safely or consistently?

We have witnessed that at each reprovision of care the service provided becomes less and less and in the end fails altogether. This is due to a simple fact that there are only so many people in our county who are willing to work as carers. As each contract is won on the basis of least cost, it is the carer who sees their pay being eroded as those bidding companies try to squeeze out a profit.

It is also evident that the same carers turn up at our doors no matter what company wins but each time the numbers are reduced.

We have also experienced these same problems when a carer does not turn up and we have to turn to the district nursing service to assist in getting people up or putting them to bed.

These are not one-off situations but they have become endemic in our services and they are increasing.

In its turn the district nursing provision has also been reduced by successive reorganisations and cost-cutting exercises coupled with a health and safety rule that requires two people for each visit. This seems like a sensible rule as long as twice as many people are made available. Unfortunately they have not, surprise surprise, which means if there are only two nurses available, as is often the case, and one goes sick then the obvious result occurs.

If we take a wider look at the problem of care in our county, we find a very frightening situation for those who are dependant on that care to survive.

The Primary Care Trust is reviewing care provision for the most seriously-affected people, those who are totally dependant, and in some cases they are being downgraded and referred back to Adult Care Services to provide their care needs.

Adult Care services are also reviewing provision and reducing the number of care centres that can provide support and in some cases have suggested that people should stay at home.

Add the problem noted above and the considerable additional burden placed on the district nurses who will have to deal with more people at home rather than in a central location as they do at the Jubilee Centre.

This circle of effect has become a spiral and we fear that the whole thing will collapse if ever a flu epidemic or a spate of summer colds occurs or dare I mention holidays.

County need to review their strategies and policies and start providing the services they were elected to provide and to stop looking at the account books. They are not running a business, they are running a public service and we are paying the penalty.

MERVYN RICHARDS,

The Ridgeway, St Albans.