Miller Frondigoun records that he was required to re-refer himself for cataract surgery as he was unable to accept the offered admission date and the preferred date he had indicated at the preliminary interview was then outside the target period (Letters, January 19).

Similar problems apply to outpatient appointments which, I am advised, operate on implied acceptance under the Scottish Government Health Department Guidance (New Ways) which advises that at least one week should be allowed to respond to the initial invite to contact the hospital.

I understand information technology systems automatically reset the patient's waiting time clock if no contact is made within that period.

The result is that where there is failure to respond there are cases where no further appointment is offered and re-referral is required.

Given the vagaries of the postal system and the possibility of other short-term contingences, operating an appointment system on a minimum seven-day response time seems unrealistic and allowing a minimum 14-day period would be fairer.

R Russell Smith,

96 Milton Road, Kilbirnie.