THE Council for Professions Supplementary to Medicine and, specifically, the orthoptists board, was fully aware of the ÖйúAƬ Quality Council audit visit to Glasgow Caledonian University both in prospect and outcome (THES, May 28).

The audit team's attention had been drawn to staffing concerns, and when no mention of any kind was made in the report we took this up with HEQC.

The response was that the audit team's hands had been tied because GCU's decisions to leave vacant a post agreed at validation and to appoint inappropriately qualified staff to other posts were taken properly in accordance with the university's internal procedures. The audit team was not allowed to consider the implications for quality or for outcome standards. Thus, from an audit (or assessment) perspective, the situation was wholly "satisfactory" and GCU given a clean bill of health.

This experience convinced the CPSM that the 1992 models of audit and assessment could not be used to ensure outcome standards for public safety in professions such as orthoptics where children's sight and cognitive development are at risk if practitioners are not fully competent.

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Sophistry about "satisfactory" ratings in "robust processes" is only of academic interest. The 1992 model works by self-assessment against self-selected targets in a mutually advantageous relationship between funding and delivering bodies in ÖйúAƬ. No parts of United Kingdom ÖйúAƬ volunteered itself as "unsatisfactory" under the 1992 regime - but then they wouldn't, would they?

For this reason the CPSM has welcomed the intent of the Quality Assessment Authority's new proposals to rebase quality assurance on objective outcome standards rather than self-assessment of process, although with reservations about the practicality of much of the detail.

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We would like to help GCU manage the transition to this new culture in respect of the PSM. We would like to help GCU manage courses that will continue at that institution. Indeed, we must if patients and not internal targets are to come first.

M. D. Hall. Registrar. The Council for Professions Supplementary to Medicine