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EDITOR,--While it is encouraging that our editorial generated interest, it is surprising that this response should occur now. The editorial was based on papers published up to four years ago, which when published generated no correspondence. Clearly, a response to the original papers would have allowed the authors to comment and would have encouraged debate in a specialist journal.
It remains worrying that M J Timmons, R W Pigott, and Augustin Cabre and colleagues fail wholeheartedly to accept the accumulating evidence which suggests that we must try harder to improve the outcome of cleft surgery in Britain. There also seems to be a continued reluctance (though not on the part of Cabre and colleagues) to acknowledge the importance of anatomical specialisation despite this being the norm in other surgical disciplines and a prerequisite to the establishment of cancer centres. Timmons, Pigott, and Anne Harding and Kim Harland criticise the study
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