I write in response to Mr Westoll's letter (Chronicle, October 24).

I was sorry that he has concerns about the investment that West Middlesex Hospital has made to build upon its excellent maternity services for its local women.

The £2million investment has been to improve a wide range of services for all women including the new natural birth centre, two new obstetric theatres and the redesign of the gynaecology outpatients department.

In context, the NHS is striving to provide the best possible experience for all women using maternity services. The recent Healthcare for London report advocates midwifery-led units as the way forward to ensure women are given choices about birth options.

The ethos of midwifery-led care and choice is carried on throughout the main labour ward setting.

We have already commenced on a refurbishment programme to update building so there is consistency between departments.

It has never been, nor will it be, the expectation that the majority of women will be on their backs giving birth. The NHS also expects its maternity services are able to provide skilled and appropriate care for those women who require more complex care packages to enable them to have the best birth experience possible.

We are confident that we have addressed the needs of all women with our new facilities.

As a positive reminder, the decision to develop our birth centre was driven by our clients in response to growing local demand for services and the limited capacity we had at the time.

It is an approach that is being adopted across the UK, so it certainly is not a phenomenon of birth by postcode. We are proud to be able to meet the needs of local women and achieve the Government targets here at West Mid by offering all options of care at a high standard to all women.

PIPPA NIGHTINGALE Consultant midwife, West Middlesex Hospital, Isleworth.