In his conference speech David Cameron complained about the criticism of his NHS policy by the Labour Party. These crocodile tears do not bear scrutiny.
The commercialisation of the NHS, although started by Labour, has been taken to extremes under the Coalition. The public have made clear that the NHS should be free at the point of delivery and provided by organisations working for the public good, not private profit. The profit motive does not best serve the sick, as several failed eye operations, the collapse of out-of-hours care contracts and the employment of poorly qualified doctors with little grasp of English demonstrate.
The devolution of control to largely autonomous trusts and commissioning groups has led to priorities being set by the market and the media, which is not the same as the public good.
A very sick child required frequent attendances at the local hospital. His parents were well educated and well-to-do. The father was sufficiently articulate and assertive to attain high political office. The family was well known, so it was in everyone’s interest to move them out of the waiting area as soon as possible.
The parlous state of NHS finances exacerbates the fact that its defining competition is between patients for resources. Each of the characteristics listed above enhances competitiveness to the point that such a family will trounce anyone else in the emergency department, which is why the Prime Minister’s experience, emotively described at his party conference, cannot be seen as epitomising access to the service.
As well as individuals competing, policy decisions simply adjust the competitiveness of different groups; waiting list targets made patients scheduled for elective operations more competitive than before. Patients with mental illness consequently moved down the pecking order. Patients with cancer were not competitive until the late 1990s. Those whose cancers present with ambiguous symptoms remain relatively uncompetitive in access to diagnostic tests.
As the financial state worsens, social and economic inequalities increase as the less competitive in society lose out.
Dr S Michael Crawford
Consultant Medical Oncologist, Airedale General Hospital, West Yorkshire
Senior health service managers have warned that unless NHS funding is increased, charging for bed and board may become necessary (report, 7 October). Before this should even be considered, perhaps NHS managers should start making decisions about which services they are going to fund in the first place.
The NHS spends between £4m and £12m a year on homeopathy. This is despite the fact that the principles on which it is based are scientifically implausible (that illnesses can be treated by substances that produce similar symptoms, if that substance is massively diluted until little or none of it remains), and that comprehensive reviews of all the available evidence have repeatedly shown that homeopathy simply does not work.
The Parliamentary Science and Technology Committee, after a comprehensive review of the evidence in 2010, recommended that the Government stop funding homeopathy. The current Chief Medical Officer, Professor Dame Sally Davies, has also expressed surprise that the NHS continues to fund homeopathy. Yet the Government seems happy to continue funding a “therapy” which is no more than a placebo.
A saving of between £4m and £12m a year might seem a drop in the ocean compared to the size of the overall NHS funding gap, but every little helps.
What is the point of all these pledges? Before the election in 2010 David Cameron gave a solemn promise not to allow any major changes in the NHS while he was Prime Minister. A few days after the election his Minister of Health told us he had been planning for seven years “the biggest upheaval in the health service since its inception”.
Cameron had talked of his dead son and spoken with sincerity and passion. I believed him. Never again.
A peace deal for the Falklands
Grace Dent (7 October) believes that for the sake of peace we should hand the Falklands over to Argentina, putting the Falkland Islanders under the thumb of their enemies; would they also consider it a peaceful resolution?
The Scottish referendum has just demonstrated to the world the UK’s adherence to the right to self-determination, a fundamental principle under international law.
Grace Dent is correct in condemning Jeremy Clarkson for his war jibe and deserves praise for her goodwill gesture towards Argentina.
Detailed history of events between about 1770 and 1833 demonstrates that the islands did belong to Argentina until usurped by Britain in 1833.
As it was not the time to transfer ownership in 1982 to a military government, it is certainly not the time to do so now to the most corrupt government ever, but the islands should be handed over at the first opportunity.
Why export the Premier League?
I believe your football editor, Glenn Moore, does the game a disservice by supporting the idea of playing Premier League games abroad.
He feels football should follow the example of the American sports that have staged games in London, like the recent NFL game at Wembley, but these sports are not “global” ones, just seeking to become so. Football, on the other hand, is already the most “global” of all sports and has no need of an impetus from the Premier League to expand.
As a general principle, I see no reason why a domestic league in a global sport needs to go “global”. When does “just one game” become two, or four, or more? And how long before “franchising” is mooted as per the American model?
Prisoners won’t get the vote
Like Andrew Bruckland (letter, 7 October), I can’t get hot under the collar about the prospect of certain prisoners having the right to vote. His parting shot that this might “even increase turnouts” is unfortunately the reason why it will never happen.
The prison service is in crisis, and those who are at the sharp end, the prisoners, have little or no say about it – they do not have the vote and they can safely be ignored.
If even a handful of the inmates of prisons were entitled to vote then sitting and prospective MPs would have to listen to their new constituents. In marginal seats containing one of the new super-prisons, the “prisoner vote” might even be worth courting.
‘British values’ laid down by the UN
This year the Government is requiring schools to actively promote “British values”, defined as “democracy, the rule of law, individual liberty and mutual respect and tolerance of those with different faiths and beliefs”.
Article 29 of the UN Convention on the Rights of the Child says that education must be directed to, inter alia, “the preparation of the child for responsible life in a free society, in the spirit of understanding, peace, tolerance, equality of sexes, and friendship among all peoples, ethnic, national and religious groups and persons of indigenous origin”, to respect for human rights and the principles of the UN Charter, as well as to the national values of the country in which the child is living.
It is surely therefore essential that the values are presented as standards expected across the international community.
Emeritus Fellow, Pembroke College, Oxford
Fellow in Law, Exeter College, Oxford
Remember Isis, goddess of affection
Why do we keep allowing Isis to change the way we name it? Every time it has a change of ambition, it changes its name. It is yanking our chain. Isis was a female god of affection, and fruitfulness. Surely this is a good name to have?
My local branch of Marks & Spencer is, in the first week of October, selling not only hot cross buns, but also rotating musical Christmas trees. Which is the more inappropriate?
Passport to happiness
The Passport Office has come in for a lot of flak recently, so let me record that I have today received my passport just five working days after applying. A great service!
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