Steve Connor reports “‘Anonymous’ NHS database could still allow patients to be identified, expert warns” (26 January).
Nobody who understands pseudonymisation claims it makes re-identification of patients impossible. It only makes it hard to do. The controls on the use of the data and the sanctions associated with them are what really protect patients’ confidentiality. This allows the major benefits to be secured with little practical risk to confidentiality. And most people are already prepared to cede a tiny risk to their confidentiality when there are big benefits (and care.data offers big benefits to the quality of much NHS care). The ability to link the same patients’ records over time is essential to realising those benefits (though we rarely need to know who the patient is). For an example of the gains see http://www.macmillan.org.uk/Documents/AboutUs/Research/ Researchandevaluation reports/Routes-from-diagnosis-report.pdf.
Dr Stephen Black
The NHS does an incredible job, delivering world-class healthcare as it struggles through yet another winter where patient demand has again risen dramatically, due to “multifaceted reasons”, not least of which I believe to be the closure of many Accident and Emergency departments throughout the country.
A&E waiting times have gained much attention, and not a week goes by when there isn’t another news story regarding a shortage of doctors in hospitals, or in GP surgeries.
Any lack of doctors or nurses is not due to a lack of applicants, but to a lack of course placements here in the UK. Major shortfalls in the NHS are made up with foreign recruits.
I am currently applying to study medicine at university. Having now left college, where I achieved three As in relevant A-levels, I am now on a gap year, and have been enjoying a long-term work experience placement at a nearby minor injuries unit.
I’m academically capable, but my prospects for gaining admission are near non-existent, and I am confident that I will be rejected, without any interviews, in what will be my second year of applying. My dream of becoming a doctor is becoming a fantasy.
The “cash for referrals” story (front page, 29 January) shows just how far the commercialisation of NHS services has gone. I do not accept that the public interest is best served by a move to a free-market economy largely devoid of public service. Neither do I accept that the economy should be run largely by the state. We need an economy where the excesses of private capital and accountability of public services are both maintained.
Whenever canvassed, the vast majority of the British people have wanted not only an NHS “free at the point of delivery”, but also one where frontline services are delivered by organisations working for the public good, not private profit. How come none of our main political parties reflect this in their policies?
Labour pledges to “repeal privatisation laws” but let’s not forget the failed Hinchinbrooke hospital was earmarked for privatisation on their watch, along with 19 others. The NHS urgently needs better ways to deliver the healthcare we all need – but I’m still waiting to hear serious proposals from any of our politicians.
Churchill: gone but not forgotten
I wish that my father could read Boyd Tonkin’s article “We’ll never see the like of Churchill again. Is that so bad?” (23 January). He was a sergeant in First Battalion Seaforth Highlanders at Omdurman Sudan in 1898 under Lord Kitchener.
His one hate was our war hero Winston Churchill, who apparently used to go forward on his horse so men would have to be sent forward to bring him back, risking their lives in doing so.
For myself I remember he slept while Roosevelt and Stalin divided Germany and Eastern Europe between them. His speeches were inspiring and helped greatly to win the war, but his self-aggrandising, and his interfering with military matters and the General Staff caused much concern.
Let it not be forgotten that Winston Churchill was Home Secretary at the time of women’s struggles for the vote. In that role he was instrumental in getting the infamous “Cat and Mouse” legislation passed which saw female protesters let out of jail once they had regained sufficient health to allow it, then re-arrested immediately after. He was against women being given the vote and was extremely rude to Nancy Astor as the first woman to take a seat in the Commons, protesting that he felt as if he “had been surprised in his bath with just a little hot water” to defend himself.
Kate aan de Wiel
Attacking Churchill for supporting eugenics a century ago is misleading. Mainstream eugenics had nothing to do with torture or murder, but was intended to reduce the suffering of future generations by family planning. That is why marital counselling is used in Israel today to reduce transmission of Tay-Sachs disease.
In Boyd Tonkin’s assessment of Winston Churchill he misses one point: Churchill’s rhetoric, which provided exactly what was needed in wartime to lift the morale of the populations of British cities undergoing devastating night-time air raids, such as the November 1940 blitz on Coventry. I know, because I was there.
Nothing inhumane about secular states
Although the first half of Mary Nolze’s letter (23 January) makes a lot of sense, please allow me to correct her distorted account of secularism.
Communist Russia was not a secular state, as secularism does not involve the abolition of religion per se, but merely the fair and reasonable separation of church and state. As an atheist secularist myself (there are also plenty of religious secularists), I would stoutly defend anyone’s right to practise their religion – provided this did not trample on the rights of others or demand undue privileges.
To suggest that Britain has something of a secular system is absurd: we have a constitutionally established church and most faiths, Christianity in particular, are given hugely unfair privileges, from state-funded religious schools to exclusive exposure on Radio 4’s Thought for the Day.
And, pace Ms Nolze, secular states are more than capable of behaving humanely; look at Canada, Australia, New Zealand, Netherlands, Sweden, Belgium, France, Ireland, Italy and others.
Zoos unfairly maligned
I cannot let Harley Miller’s letter (28 January) go unchallenged. While 19th-century zoos may have been about little more than entertainment for the masses, such is most certainly not the case today. Conservation and education are the overwhelming purpose of modern zoos.
There are many animals that have been brought back from the verge of extinction because of breeding programmes instituted by zoos; to quote just one example, consider the Arabian oryx. Exterminated in the wild, and only saved, and later re-introduced to the Arabian peninsula by the efforts of London Zoo.
Education, whereby people can visit zoos to see and appreciate the creatures which share our planet, and read of conservation projects in parts of the world where human activity has placed a burden on the native wildlife, is also of the utmost importance.
Inquiry into the inquiry needed
Do we need an inquiry into why the Chilcot inquiry has not been published, more than five years since it started? If so, would it manage to publish its findings before the Chilcot inquiry publishes its own?
West Bromwich, West Midlands
Apple profits but will its workers?
Now that Apple has posted record quarterly profits how can it continue to justify the working conditions of many of its employees? Time for the living wage I think.
It’s always right to fear spads
In Donald MacIntyre’s Sketch (28 January) he mentions the issue of “Spads” – special advisers – being involved in a recent by-election. On the railways “Spad” can also refer, I believe, to “signals passed at danger” – this should be a warning to us all.
Gone with the wind
“Winds leave thousands without power” (report, 12 January). Now that’s what I call an ironic headline.