The Government must negotiate with the BMA
The NHS relies on the goodwill of its staff. If even 5 per cent of the current junior-doctor population is driven overseas or leaves medicine due to the proposed changes to their contract, the NHS will become untenable, forcing services to be transferred to private providers.
If the UK Government believes in maintaining our NHS, it must surely enter into genuine negotiations with the BMA, providing concrete assurances and an updated time-frame to deliver a contract in the best interests of junior doctors, their patients and the wider NHS.
If it fails to do so, this is the clearest indication to date that maintaining the NHS in England is not a priority of our Government.
Dr Kitty Mohan
Jeremy Hunt is motivated by myths
Jeremy Hunt (3 October) repeats several incoherent myths about weekend mortality and the junior-doctor contract imposition.
First, he fails to mention the withdrawal of the vital hours safeguards, which currently prevent doctors from working excessive and unsafe hours.
Second, he disingenuously claims that he doesn’t want to see junior-doctor pay cut, despite the fact that it is likely that many will see their wages fall significantly, thanks to the reduced reward for antisocial work and the loss of pay progression.
Third, he recklessly repeats the myth of 11,000 “preventable” weekend deaths. In fact the research on which this propaganda relies states that it is “rash and misleading” to assume that any of these deaths are preventable; the authors of this research include the medical director of NHS England, Bruce Keogh.
The reality of Hunt’s junior-doctor contracts is a return to the dark days of routine unsafe excessive hours. This will further demoralise and fatigue an already overburdened junior-doctor workforce, and result in significant avoidable patient harm.
The removal of hours safeguards, combined with the lack of reward for antisocial hours, will have consequences entirely negative for patients and doctors alike.
Dr Ben Dean
Doctor's ethics must not be compromised
I’m sure GPs across the country are incensed to hear that bribes are being offered to interfere with their clinical decision-making (“Plans to reward GPs for cutting hospital admissions”, 2 October).
In my last few years as a GP, financial inducements were pushed on us to reduce prescribing, and several other schemes were suggested that I regarded as unethical. To pay GPs more to not refer patients is disgraceful but sadly totally consistent with this Government’s approach.
The Government wants a much-loved service to become a business. Jeremy Hunt and David Cameron live in a world where they think no one would dream of lifting a finger to help someone else unless paid for it.
One reason most GPs oppose what this Government is doing to the NHS is that they are being forced to become rationers of their own patients’ care – this is inconsistent with the trusting relationship needed.
Dr Paul J Hobday
Cameron wants corporate healthcare
First you deprive the NHS of money and its staff of decent pay. Then the hospitals fail, and staff and patients become demoralised. Then you announce that, as the NHS can no longer function, healthcare must be privatised. Then you have first-class healthcare for those who can pay, and a minimal, very basic service is provided for the poorest.
Then Mr Cameron has just what he wants – a health business just like they have in the US, run by the same companies.
Integration the way forward for NHS
An integrated health and social-care system would reduce the unnecessary number of hospital admissions significantly. As such social care, the poor relation to the NHS, needs to be recognised in the forthcoming Comprehensive Spending Review.
Professor Martin Green
Chief Executive, Care England, London E1
Nick clegg is right about uk drug laws
At last, a serving MP has ignored the howls from the tabloid press and the stubbornly ill-informed and has launched a campaign to get some changes to our out-dated, draconian drug laws (report, 2 October).
For 50 years these laws have made criminals of drug users; have locked up hundreds of thousands of non-violent drug offenders; and been responsible for thousands of avoidable deaths in the UK.
As long as the supply of drugs is left in the hands of criminals, and users have no idea of the strength or purity of the substances they are taking, these tragedies will continue. The latest government figures show accidental deaths at 50 a week now, the highest since records were kept.
I hope many more MPs, MEPs and other influential people will be brave enough to join Nick Clegg, and that we will at last get rid of these cruel and lethal laws.
Nick Clegg is correct to say drug laws across Europe need reform.
Prohibition doesn’t work, and punishment simply drives drugs underground.
The baffling situation in the UK is that cannabis, with demonstrable benefit for those with health conditions such as multiple sclerosis and epilepsy, is on a level of such criminality that we are effectively penalising the sick.
The current doctrine forbids research institutes from studying the benefits of drugs for medicinal purposes. In the meantime, people who use drugs for medicinal purposes are criminalised.
It is time to have an open and honest debate and seek a better approach, in the UK and abroad.
How refreshing that a one-time deputy prime minister is challenging our outdated attitude to drug use. I write as a retired GP who failed four young patients who died of heroin overdose simply because the drug was illegal and they felt unable to use the health services to deal with their problem for fear of incarceration.
As a septuagenarian I well remember smoke-filled bars, dinner parties, and public transport which, thanks to public health measures and education, have disappeared.
All mood-altering substances should be brought into the arena of public health rather than criminal justice. Then, as has been found in Portugal and Holland, we can begin to reduce the harm.
Dr Nick Maurice
Does marten mix-up malign the pine?
Tony Crofts (Letters, 3 October) warns us about pine martens damaging cables in cars in Poland. The culprits are much more likely to be beech martens, which are common in towns. Denning by that species in warm engine compartments has become regular across central Europe, with up to 40 cars being damaged per day in Switzerland alone.
By contrast, pine martens live in mature forests, where opportunities for such vandalism are rather limited. Most of us will share Michael McCarthy’s joy (report, 29 September) at the spread of this beautiful wild mammal.
Brighton & Hove
Air quality: action is needed
The Defra website has provided UK air-quality records since at least 1990. How is it that the emissions from so many diesel engines which seriously exceeded the stated and mandatory limits were not noticed? Either the monitoring regime is totally inadequate and a waste of money, or the results were ignored. Both cases indicate urgent action is required to monitor air quality in the UK to EU standards.
Pooh to this story of garden bridge
Every park or public space has conditions of entry to ensure a safe environment. (“Garden Bridge: Pooh sticks, balloons and making speeches banned on London’s soon-to-be-built bridge”, 1 October.)
In this case, one of these conditions states that “no person using the Garden Bridge shall drop from the Bridge any item with the exception of devices intend for the purposes of saving lives”.
Some people have suggested that this means that Pooh sticks will not be allowed on the bridge. This is not the case. We will only prevent people throwing items off the bridge if it is deemed to be unsafe for pedestrians on the bridge or for people using the river below. We wish players attempting a game the best of luck keeping track of their sticks from 20m above the fast-flowing River Thames!
Garden Bridge Trust,
Motorists’ manners worse than ever
It’s true that manners are getting worse (Voices, 1 October). I have heard more people hooting in the past 10 weeks than in the previous 10 years, even when it can make no difference to the speed of the traffic – that is determined by someone 10 cars ahead of whoever is doing the hooting.
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