Dear Editor,

There is a current trend towards the implementation of quality systems in haemodialysis, which is without doubt beneficial for all, both patients and health professionals. The interest of nephrologists is shown in the recent abundance of publications on this issue.1,2 However, I would like to discuss3 this new aspect of our study both verbally and physically. In order to demonstrate the virtues of the quality indicators, some of the articles4,5 use very weak basal data and therefore the “improvement margin” is very wide. This should lead us to ask why we are neglecting these patients.

In my opinion, there must be a sufficient “quality and quantity” of health professionals to provide proper treatment for chronically ill haemodialysis patients. I also believe that the Scientific Organisations involved should, as far as possible, place pressure on the corresponding administrations, so that all haemodialysis patients are treated by qualified nephrologists that the ratio of patients per nephrologists and nurses is acceptable and that paperwork is reduced to ensure greater contact between the nephrologist and patient.