Letters: Care for the elderly

We need a revolution in thinking about care for older people

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Sir: I was pleased to see that you made the care of older people front-page news (27 March). Older people are the core clients of NHS hospitals, accounting for some two-thirds of admissions - with an average age of 67. They also provide the bulk of work for general practitioners and for the social care system - with over 500,000 people in long-term care and millions more receiving social services at home. Yet, despite the good intentions expressed in the Government's National Service Framework for Older People in 2001, we are still a long way off putting their needs at the forefront of service planning.

Many patients never receive comprehensive specialist assessment. In many cases, problems such as falls, immobility, confusion or "failure to cope" at home have medically treatable causes, or would benefit from professionals such as physiotherapists or occupational therapists. Yet the capacity in the system to deal with these specialist needs is lacking.

Many of the targets trumpeted in the NHS plan are about the ability of articulate younger people to see their GPs at a time of their convenience, or choose and book their operations. Yet there are large numbers of frail, vulnerable older patients with complex needs who often have no advocate to speak up for them.

Society, media values and the attitudes of the voting public, as well as those of some health and social care professionals, are inherently (if unwittingly) ageist. Witness the media outcry over Herceptin for young women with breast cancer vs the unpublicised yet lamentable failure to treat osteoporosis, falls, dementia or incontinence - problems which usually affect older people. Or the use of the term "the elderly" in your own article - as if all older people were as one. Or the lampooning of Ming Campbell on his election to the leadership of the Lib Dems for daring to be 64!

We need a change in attitudes to older people, akin to the ones over child labour, women's rights or homosexuality. And a discussion about the resource implications of getting older peoples' care right. If we do so, we will simultaneously revolutionise the organisation of health and social care systems.

DR DAVID OLIVER

SENIOR LECTURER, ELDERLY CARE MEDICINE, UNIVERSITY OF READING

Clarke's clash at the cathedral

Sir: I was very surprised to see a letter from Charles Clarke, the Home Secretary, who is my father's MP(28 March). Mr Clarke objects to a piece by Matthew Norman in which he takes Mr Clarke to task over a disagreement in Norwich Cathedral a fortnight ago. Mr Clarke and my father, Canon Phillip McFadyen, have since apologised to each other. I published an account of this incident on my blog a couple of hours after it happened and this account was picked up by the mainstream media.

I did not say, as Mr Clarke claims, that the Home Secretary had "behaved" in a very nasty way: I reported that my father had said that he had "looked at him in a very nasty way" and said that he was being insulted by my father, who was then dismissed by Mr Clarke.

My father was certainly somewhat agitated when he approached the Home Secretary, and I reported this. But to say that he "talked over the top" of the Home Secretary and would not allow him to answer questions is extraordinary. It is in no way congruent with my father's account, and with his great distress afterwards. When my father called me straight after the meeting, his first words were, "I tried, Rachel, I tried to ask about the public inquiry, but he wouldn't answer me; he looked at me in very nasty way and he said that I had insulted him, and he dismissed me with the words, 'Get away from me, you are insulting me.' "

My father's distress at not getting an answer to his question was apparent and seen by many of his colleagues, who have since sent him supportive messages. Mr Clarke has a reputation for being a "fearless political bruiser", who enjoys the rough-and-tumble of Westminster life, but his brusqueness and refusal to answer my father's question when challenged immediately after a Norfolk clergy meeting seem to have surprised many. I took care to be as accurate as possible in my blog entry, and I stand by what I wrote.

My father and I are looking forward to meeting Mr Clarke in the ten minutes the Home Secretary has allocated us next week, to discuss the matter of a public inquiry into the 7 July bombings, something that I and many other survivors are still seeking.

My father has refused all media follow-up to this story. I myself had considered that the matter was closed, since it was clear that both regretted the incident and a meeting was now in the diary. I can see that Mr Norman's piece may well have caused a strong reaction in Mr Clarke but that, surely, is between Mr Clarke and Mr Norman, not my father or me?

RACHEL NORTH

LONDON N4

Sir: The pitiful letter from Charles Clarke complaining of his treatment at the hands of your columnist Matthew Norman and his description of his unhappiness at being "hectored" by Canon McFadyen in Norwich Cathedral does little to enhance his status as a strong-minded and determined member of Tony Blair's Cabinet.

If we are to believe that Mr Clarke is of a mind to push through some extremely unpalatable new laws restricting our personal freedoms then he needs to toughen up a bit. Allowing a man of the cloth and one of The Independent's journalists to get under his skin makes me wonder whether there could be a heart beating in there after all. With this in mind, perhaps he can be persuaded to review his plans to shackle us all to our biometric ID cards and snoop on us with his linked CCTV cameras.

STEVE MACKINDER

DOWNHAM MARKET, NORFOLK

Israel will have to live with Palestinians

Sir: In your article "After Sharon" (21 March) you quote a consultant working for Sharon's deputy, Ehud Olmert, as saying "Most Israelis are not looking for peace with the Palestinians. They are looking for quiet, for security and they want the fence to be high enough so that they don't have to see them any longer."

If that assessment of Israeli public opinion is accurate then this is disastrous news for Israelis, Palestinians and anyone concerned about the rising extremism that is fuelling global terror. Whilst Hamas crudely refuses to recognise Israel's right to exist, Israelis seem to be saying exactly the same thing about their Palestinian neighbours.

Israelis may feel they are on a winning streak in their war with the Palestinians as they use their security fence to annex more territory, but just as America has found in Iraq, winning a war can be relatively easy but winning the peace is quite another thing. Like it or not, Israelis will one day have to live alongside a viable Palestinian state.

GRAHAM SIMMONDS

LONDON SW4

Ways to pay for political parties

Sir: Johann Hari makes a very poor argument for state funding of political parties ("If you don't pay for politicians, the rich will", 22 March). If I wish to give £3 to a deserving political party, I can already do so without registering my political allegiance with the state or relying on the state to sanction my choice. State funding takes away my choice to do something else with that £3 and ensures that it pays for political propaganda.

If political elites vote for state money to be used for their own purposes, it is nothing more than corruption. The state cannot force people to be interested in politics and nor should it take their money to implement such a scheme.

MARK HARMS

CLARA VALE, TYNE AND WEAR

Sir: There is an astonishing resemblance between the "loans for peerages" scenario today and the "forced loans" or "benevolences" in exchange for Government favour raised by Cardinal Wolsey for Henry VIII. One old merchant complained in 1522 that this did not happen under King Richard - "a good king who did govern through Parliament". The reputation of parliamentary democracy is lower today than it was under Richard III.

DEREK J COLE

HASTINGS, EAST SUSSEX

Pubs do still serve beer

Sir: John Walsh (Magazine, 25 March) felt that £27 for a bottle of wine in the Pot Kiln in Berkshire was "rather steep". As the Pot Kiln is a pub, a pint of beer would have set him back far less and would no doubt have pleased the accounts department at The Independent. Not only does the Pot Kiln serve beer, it also brews its own ale, a point mysteriously overlooked by Mr Walsh.

Its West Berkshire Brewery produces Brick Kiln Bitter solely for the pub, along with seven other beers for wider distribution and a bottle-conditioned Full Circle, which would have proved a perfect companion for Mr Walsh's meal.

I cannot fathom why so many restaurant reviewers regularly dine in pubs and never mention the beer. It is a disservice to the British brewing industry, in particular the small army of 500-plus micro-breweries, such as West Berkshire, that have brought choice and diversity back to beer drinking.

ROGER PROTZ

CAMPAIGN FOR REAL ALE ST ALBANS, HERTFORDSHIRE

Iraq death toll

Sir: With the violent death toll in Iraq reaching 50-plus per day, it has returned to the rate of killing which the Pentagon website and our own Jack Straw cite as being achieved by Saddam Hussein during his tenure of office: a total of between 450,000 and 500,000 over 24 years.

MAURICE VASSIE

YORK

Mill rebukes Blair

Sir: There can be no surprise in the fact that the current government should wish to tiptoe quietly past the bicentenary of John Stuart Mill (Opinion, 27 March). Was it not he, after all, who came up with the following, anathema to New Labour, Old Labour and all Labours in between ? "The only purpose for which power can be rightfully exercised over any member of a civilised community, against his will, is to prevent harm to others. His own good, either physical or moral, is not sufficient warrant."

TIM HINCHLIFFE

BECKENHAM, KENT

Veto denied

Sir: Peter Tatchell was never commissioned to write an article for our Equality Report, so the claim that it was vetoed is completely inaccurate (Pandora, 20 January 2006). Hugh Hill is not responsible for commissioning content for the report and is not the publisher. He is a photographer who was commissioned by the Greater London Authority to produce some images for the report.

JOY JOHNSON

DIRECTOR OF MEDIA AND MARKETING - MAYOR OF LONDON LONDON SE1

Desperate footballers

Sir: Dominic Lawson doesn't know what he is talking about (Opinion, 28 March). One cannot compare player behaviour in a fairly passive game like cricket to the extraordinary physical demands of 90 minutes of football. The reason footballers become demanding and desperate to win is in the very nature of the demands placed upon them. As for rugby, it is effectively organised physical battle. It cannot allow itself to fall one notch into outright anarchy: hence the players tend to maintain control; they simply have to.

HUGH HASTINGS

FALMOUTH, CORNWALL

Reasons for a Rolls

Sir: What value Has Brian Sewell's comparison of a vintage Rolls-Royce with a modern Honda ("Sorry, I'd rather have a Honda", 28 March)? He could just as well have said "I would rather have a goldfish." It depends what you want. If you are looking for a wedding car, a hobby or an investment, a classic car is an option. For everyday motoring a Honda would be fine. If you want something to make your waiting room more relaxing, try a goldfish.

VINCENT HAMMERSLEY

COVENTRY

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