As has just been pointed out, 6000 people earning over 140,000 is not many at all. I work in the NHS and see the incredibly long hours which many hosptial consultants put in, working weekends and evenings. They carry an incredible amount of responsibility. The same is true of the senior hospital management (and it's usually just the chief exec who earns this much, except in the very large hospitals). These are people who could earn a lot more money in industry, especially those who work in London hospitals. Does anyone know how much you have to earn to get a mortgage on a 4 bed family home in East Dulwich these days? The King's charity trustess clearly have a responsibilty to keep the funds looking as healthy as possible, and like most charities I would imagine over the past few years their investments have suffered and donations are down. Possibly this is the reason for them trying to raise some more awareness of their work, which may in turn lead to increased donations. I imagine the reason that they wrote to recent patients, rather than just did a bulk mail drop locally is because many people choose to come to Kings from outside of the local area, and many people in the local area may not go to Kings because instead they have their hospital appointments closer to their work. As patients of King's who may benefit from the work of the charity, this makes everyone "stakeholders" in the charities work, and as such should be given the opportunity to be kept up to date or to become more involved if they wish. On the subject of "the intrusion" that receiving such a letter would cause, in the past few weeks I have two very persuasive and passionate individuals from different charities knock on my door asking me to make a regular direct debit payment. Whilst I don't like this intrusion, they are doing what they have to do to raise funds in a competitive environment, and do not object to them doing this. However I know what I think would be more upsetting and confusing to all those vulnerable people that previous posters have been so worried about receiving the now infamous letter.