We would not dispute many of the points Martin Ince makes in his article about the development of medical research in London ("Health fails to bring in cheque", THES , October ).

The capital is indeed an acknowledged centre of excellence for its clinical services and its medical teaching and research, potentially rivalling any other city in the world. Its large population base and the international reputation of its medical schools and research institutes are a magnet for the cream of teachers, researchers and practitioners from this country and abroad. The resulting critical mass of expertise is not only of immediate benefit to patients in a wide area of Southeast England and beyond, but also to future generations through the cutting-edge biomedical research for which London is held in worldwide regard.

Ince is also right when he suggests more remains to be done to ensure the financial benefits of London's medical research potential are exploited. Many of the factors that contribute to London's international pre-eminence also make it a far greater challenge to maintain its strong position and to bring about necessary change. Sheer size is one factor. Problems of transport, cost of living and securing academic and residential accommodation are also not disputed.

Furthermore, London is only beginning to emerge from a quite unprecedented period of upheaval within the health service. The London medical schools, too, are consolidating after a programme of mergers designed, among other things, to strengthen research in medicine and the sciences that underpin it. The heads of those schools have been working, and continue to work, incessantly together and with our colleagues in the NHS to build on the excellence that exists in London's medical research and to develop its economic potential. Ince's claim, therefore, that "even the regular meetings of the deans of London's five medical schools have foundered for lack of common ground on how to work together" is not only without basis, but also risks jeopardising the many achievements already being made.

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R. D. H. Boyd
Principal
St George's Hospital Medical School

G. R. D. Catto
Vice-principal
King's College London

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C. R. W. Edwards
Principal
Imperial College School of Medicine

R. J. Levinsky
Vice-provost (Biomedicine)
University College London

D. M. Williams
Acting warden
St Bartholomew's and the Royal London School of Medicine and Dentistry