SIR - Fair, fair, fair, fair, weak and weak . This is how the Care Quality Commission rated our two Hertfordshire Primary Care Trusts in its recently-published NHS Performance Ratings for 2008. However, I could sum it all up in a single word: disgracefu

SIR - "Fair, fair, fair, fair, weak and weak". This is how the Care Quality Commission rated our two Hertfordshire Primary Care Trusts in its recently-published NHS Performance Ratings for 2008.

However, I could sum it all up in a single word: "disgraceful".

The CQC goes on to say: "Of concern is the fact that 13 of the 31 trusts have never scored higher than fair for either overall quality or financial management."

The 13 of the 31 trusts that have scored double weak and have never scored higher than fair for either overall quality or financial management are as follows: East and North Hertfordshire Primary Care Trust, West Hertfordshire Primary Care Trust (plus 11others).

I am the owner of a group of local pharmacies, all based in Hertfordshire.

We serve around 20,000 Hertfordshire people every month.

Most of my staff (myself included) live in Hertfordshire so we believe we have a good understanding of their aspirations and health needs.

Yet our relationship with the PCTs is blighted by a litany of un-answered emails, letters and phone calls.

Despite it being government policy that small businesses like mine should be paid promptly, the PCTs can take many months to settle their bills.

While the CQC monitors the PCTs, they in turn have a duty to monitor local pharmacies.

Although we have passed our monitoring visits with no difficulty, in the past we have found their approach to be bureaucratic, unreasonable and unhelpful.

This simply frustrates us in wanting to provide better pharmacy services for patients and the public.

Despite it being government policy for the PCTs to issue us with NHS email addresses so we can communicate better with local GPs they have failed to do so

Despite it being government policy that local pharmacies should be able to provide the much-vaunted NHS heart checks the PCTs have excluded us

Yet in a recent audit we discovered that patients' had returned nearly �11,000 of unused prescription medicines to us in a single month.

Scaled up that would translate to �130,000 of unused NHS resources annually - which if our pharmacies are typical could mean �M4 of money wasted across Hertfordshire.

The NHS is not immune from the recession.

With a little imagination there are many ways local pharmacies could help the PCTs save significant sums - and benefit healthcare in Hertfordshire - if they could be persuaded to work with us.

I will resist the urge to go on and on. Instead I think we should demand answers - not more "spin" - from our PCTs. (Herts Advertiser, October 22)

It seems they are answerable to no one.

Surely there must be some accountability for this disgraceful waste of public resources?

GRAHAM PHILIPPS

Manor Pharmacy Group

Beaumont Avenue, St Albans