The Council for Professions Supplementary to Medicine welcomes and supports the serious and extensive coverage given to its field (THES Synthesis, January 20). However a number of points need to be made to help redress any misleading impressions caused by the complexity of the issues involved and to enable the data supplied properly to be evaluated.

First, in Professor Ellis's article, it is the duty of the individual professional boards operating within the framework of the CPSM to register practitioners and approve individual educational institutions. This is important because the boards are comprised of a majority of members elected directly from the professions. It is this professional control and autonomy which has helped the boards (and the professions) to respond so effectively to the challenges of higher education.

Second, both council and board would agree with Professor Ellis's analysis on the desirability of degree-level education and training for the professions supplementary to medicine and have over the past decade recommended a wide range of degree courses to the Privy Council for approval.

Third, I must make it clear that a reintroduction of national examinations is not known to be on the agenda for any of the seven professions falling under the Professions Supplemntary to Medicine Act.

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Finally Professor Ellis's remarks about quality assessment touch on one of the most complex and dynamic areas of work in the professions. In England a study is currently reaching fruition organised by a number of the stake-holders in health education (notably the ³ÉÈËVRÊÓƵ Quality Council and the NHS Executive) which addresses the issue of quality control.

Moving now to the data supplied by the CPSM in figure 11, I regret seeing this in print as it serves as a reminder that raw figures uninterpreted can often be misleading and problematic. An additional problem is that different categories of data have been conflated in this particular table. The data relate exclusively to registration.

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In Lesley Wright's article on orthoptics she describes the CPSM as the "arbiter of standards" and the "stautory regulatory body" which "validates" course. In fact the board (her professional peers) exercises the first two functions. The board does not validate degrees. The boards have laid on them the duty of approving courses (validated by institutions) which convey the necessary knowledge and skill for the practice of a given profession and to approve institutions in which these courses take place.

We have commissioned a study into the operation of our Act. I invite any readers with views to share them with us.

R. PICKIS

Registrar, CPSM