Forget referendums: this is the answer to the UK’s democratic deficit

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A citizen’s convention could be put to parliament by 2020 (Getty)

Many of us feel powerless and fearful about the future of democratic politics. There is a lot wrong with our democracy but what do we do about it? How do we do a stock take and put it right? Crude referendums have clearly failed, the Alternative Vote campaign, Scottish Independence and Brexit may show a thirst for democratic debate, but they prove the divisive nature of decision by referenda.

No one now wants to settle by referendum complex questions around English devolution, reform of the House of Lords, votes for 16- and 17-year-olds, electronic voting and many others that desperately need attention. It’s time we initiated a new device - a citizen’s convention. This would be a structured two-year-long national conversation on issues of democratic reform in which everyone in the UK could participate in producing proposals by consensus that could be put to the 2020 Parliament.

Already the parliamentary leaders of Labour, Greens, Lib-Dems and Ukip plus senior Conservatives have signed up to such a proposition under the auspices of an impartial Convention. What’s important is that we listen to the British people's frustrations with elitism and their ambitions to run their own affairs, and come up with a set of proposals to make democracy fit for purpose.

A citizens’ convention – aided by a million on line founding fathers and mothers – would help break us out of our Westminster, Whitehall and media echo chamber and bring together the voices of those outside as well as inside of the “political bubble”. Instead of them talking at each other, they can talk with each other in a spirit of education, trust and compromise. We have proved that a simple Yes or No does not produce a policy for a democracy. There is another way, and all of us in politics should combine to make it happen.

Graham Allen, MP for Nottingham North, former chair of the Political and Constitutional Reform Select Committee

Address supplied

Is the answer to the NHS crisis staring us in the face?

Last week in the House of Commons, Health Secretary Jeremy Hunt described the NHS as “Britain’s most precious public service”, a view that is rightly upheld by the British people. It comes as little surprise that with Brexit, the transition to a Conservative Government, a new Prime Minister and record levels of pressure on the system, there has been a storm of dramatic change over the past 12 months, leaving the country in turmoil.

In a recent report, the Nuffield Trust summarised data on operational pressures escalation levels for past month and found that 23 trusts were operating at the maximum level of pressure (level four). Level four runs in parallel to more commonly used terms like ‘black alert’ – described by the Nuffield Trust as “the operational difficulties hospitals find themselves in when demand for their services outstrips their capacity to provide it”. This definition describes perfectly the issue that we are all trying so desperately to address.

Our answer to this is that the burgeoning pressure on our healthcare system must be supported in more than one place. To use an analogy, if one beam is used to support the roof of a whole house – the beam will inevitably collapse and the house will fall. If we put up more beams the weight of the roof is spread out and the house remains standing.

The option of private healthcare has always been present and for some people it works. For many, however, the cost makes it an unrealistic option. This is why a hybrid model that sits between the two should not be overlooked. A report by think tank The Kings Fund revealed that 70 per cent of female GPs work part-time. The report also said that family doctors were losing faith in full-time clinical work for fear of “burn-out” due to the “intensity” of their workload”. Our healthcare system is therefore struggling on all sides. Levels of patient demand continue to rise and NHS doctors are being driven out by unsustainable working conditions. Health-tech options like Doctaly allow NHS GPs to work as much or as little as they choose for a fee that is far more affordable than traditional private healthcare for patients. While this option will not be suitable for all, for some the convenience is worthwhile and channels some of the pressure away from over-subscribed resources.

It’s easy to have a critical knee-jerk reaction to alternative models that sit between the NHS and private healthcare but in a winter with forecasts of snow and healthcare warnings that people should refrain from calling the emergency services unless they are in a life-threatening condition, opening up alternative options could be a significant step in the right direction.

Dr Dinesh Silva, co-founder of digital healthcare service Doctaly

Address supplied

We are prepared to pay the price for the NHS

Linda Piggott-Vijeh seems to take a rather ambivalent view with regard to the reported crisis in the NHS (Letters, 13 January). Whilst accepting that there is a “humanitarian crisis” in the NHS due to many years of underfunding, exacerbated by the changes in demographics, she lets successive governments off the hook by appearing to blame the end user for not wishing to pay the real cost.

I suspect most people, particularly Independent readers, realise that there is no money tree, but they do expect governments to prioritise public expenditure for the national good. This might mean raising taxes to offset the increasing demands on the NHS. Governments don't like this and often seek to appear to be reducing taxation rates particularly in the run up to elections. So governments can be held responsible for the NHS crisis by dodging the issues.

Implying that health workers should “put up or shut up” because other workers are also being exploited is no argument. Putting health workers under press is unsafe and I would prefer to be treated by a doctor, nurse or paramedic who had not just had to work a 12-hour shift with hardly a break. As Dr Rachel Clarke wrote in her article of 12 January, (As a junior doctor, I see that the Government is covering up a crisis in the NHS), she wondered for the thousandth time how a country that can afford a £42bn new train track could simultaneously subject its most vulnerable citizens to such abject inhumanity.

The NHS and care services are in crisis. The Government must address the problem urgently and, even if it means a modest tax rise, must invest in this most civilised of concepts – high quality healthcare, free at the point of delivery.

Patrick Cleary

Devon

Are disabled people not supposed to travel?

I'd like to second everything James Moore said in his article, (It’s time to hit businesses fail their disabled customers where it really hurts – in the pocket, 10 January), regarding easyJet and OCS at Gatwick airport.

Last June we booked with both for a party of four, two with mobility issues and two without. Our flight was delayed 24 hours. easyJet's opening gambit was offering rooms at three different hotels in a 45 minute radius of Gatwick. Instead we ended up in standard rooms at the hotel - so no showers possible. We are still waiting for a refund for the expenses incurred, including an eye-watering increase in the cost of vehicle hire. The seats allocated on the replacement flight were in row 28. OCS didn't preload us and had a shortage of chairs so I ended up close to passing out and my mum had a panic attack looking at the state of me. It wasn't any better on the return flight when we got to Gatwick.

For business I travel out of Birmingham frequently, OCS are appalling there too. Several times I've been left waiting for someone to help me in the car park and ended up having to ask total strangers for assistance. I no longer drink before travelling because I can't guarantee that they will have sufficient time to get me to a toilet. On one occasion I got thrown out of the disabled waiting area because I wasn't flying but waiting for an inbound colleague.

In the countries I've travelled to since I got my disability the service and support is brilliant, it's only in my home country that I've become a second class citizen. Perhaps the disabled are simply expected not to be seen or heard?

Samantha Butterworth

Oxon