Editor,—We agree with the views expressed by Gatzoulis et al concerning the need for dedicated clinics for adults with congenital heart disease.1 We started such a clinic in 1993. Initially this was once a month, becoming semimonthly in 1995 and weekly in 1999. The clinic is in a district general hospital serving a population of 650 000, and the initial numbers may have been present because of the early work of Bill Oliver in establishing catheter facilities on this site and the link with Great Ormond Street visiting cardiologists. One of us also runs a paediatric clinic and the other has experience in adult congenital heart disease.

Forty three per cent of our 260 patients are male, and 25% of …