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As a former vice-chancellor and now the chair of an NHS trust, I have been struck by the similarities between the government's reforms of higher education and health.

Both sets of initial policies were subject to a hotchpotch of amendments that have resulted in veritable dogs' dinners; both seek to bring in a wider range of providers, particularly from the private sector, allegedly to drive up quality; both will struggle to establish effective regulation; both involve radical and rapid changes that are, in effect, experimenting with people's lives (with a high risk of going badly wrong); and both are fundamentally flawed because they regard education and health as commodities, whereas in truth students and patients are not "consumers" but are integral parts of the processes of learning and recovery.

Despite the similarities of the reforms, the responses of senior professionals and managers in health and education have been strikingly different. The initial proposals for health reform were strongly challenged by doctors and health leaders, resulting in the plans being substantially moderated. It is not obvious to me that university leaders have taken an analogous stance: certainly, they have not changed the main thrust of the propositions one bit; indeed, it seems that most were largely silent, and some even complicit, in the travesty that is about to befall higher education.

Mike Goldstein, Streetly, West Midlands