Letters: Care scandals

Tuesday 07 June 2011 00:00 BST
Comments

Sean O'Grady is right to argue that the Government must ride to the rescue when vital public services such as Southern Cross fail, but it does not follow that private provision represents a poor deal for taxpayers. Southern Cross won't be the last private 'partner' to hit the rocks", 2 June).

Government must be prepared to ensure that vital services such as care homes are available to users without disruption, when providers fail. But we shouldn't kid ourselves that financial mismanagement only happens in private companies. Let's not forget the half-a-billion pound overspend in the NHS in 2006. What matters is that those responsible for failure are accountable. At least private shareholders can be made to pay the price for their incompetence.

Nor is it tenable to claim that profit-making by private firms generally entails a poor deal for taxpayers. Quite the opposite. A review of the evidence on outsourcing by the respected economist DeAnne Julius, commissioned by the last government, showed that outsourcing tends to reduce costs by between 10 per cent and 30 per cent. The same evidence suggests no deterioration, and possibly some improvement, in the quality of the services provided.

The Southern Cross situation is a scandal. But such problems are not unique to the private sector.

Ian Mulheirn

Director, Social Market Foundation, London SW1

When I trained as a geriatrician in the 1970s, people with learning disabilities and the elderly who needed nursing care were cared for directly by the NHS, and local authorities provided care in their own (owned) residential homes for elderly people who could not fend for themselves.

There were relatively few privately owned facilities and these were the province of the wealthy.

Admittedly, NHS and local authority care were sometimes imperfect, but there were inspecting authorities with real teeth, such as the Health Advisory Service. Such bodies were obliged to make their findings public, which was not to the taste of local or national politicians.

The Thatcher government of the 1980s hived off NHS and local authority facilities to the private sector, so placing politicians at arms length when things went wrong, and of course since the market would ensure improved standards regulatory and inspecting bodies would need to be less powerful (or vigilant).

Competition would drive poor providers out of business. But who steps in to rescue the vulnerable casualties? The dear old much-"reformed" NHS and its local authority counterparts, while Cabinet members stress that these things are not their own direct responsibility, but "something must be done" (and must no doubt be accommodated "within existing resources").

The Secretary of State for Health will no longer bear direct responsibility for the provision of health care; that will be the job of GP consortia (until they reinvent local and regional health authorities for the third – or fourth, I've lost count – time). The "rationalisation" of various benefits will only add to the pressures on "clients" and on their increasingly elderly relatives, who will be expected to work into their 70s while providing support for their 90-something parents.

Dr D J Walker

Macclesfield, Cheshire

Drug prohibition makes no sense

Nowell Snaith (letter, 6 June) states that "the negatives of cannabis and ecstacy outweigh the positives".

Presumably by this the writer means that a very small proportion of the population with a genetic predisposition towards mental illness, that could be exacerbated by extremely high THC-content cannabis use, should be protected at the expense of the thousands of responsible recreational users who over the years have not developed any kind of psychosis.

By this logic one would also argue that peanuts should be banned because some people are allergic to them.

And where does the idea that any relaxation of our drug laws would lead to millions of people becoming addicts come from? It doesn't make sense, on two counts: first, cannabis, LSD and Ecstasy are not physically addictive; second, just because something is available doesn't mean that everyone will use it. I do not drink or smoke, even though both are freely available; the reason is that I don't like what these substances do to my body and how they make me feel the day after. People choose the drug that suits them.

Most addicts become addicts because they have addictive personalities, not because they have tried something and instantly become enslaved by it.

Even if you argue against legalisation there can be no good reason to argue against decriminalisation, which would prevent the worst thing that recreational drug use can do to most users – gain them a criminal record.

Joe Hartley

Society for Responsible Drug Use, London SW17

"Oh, the children! Won't somebody please think of the children?"

When reason, logic, evidence and coherent argument are no longer available to support your puritanical position, you can always resort to emotive pleas to protect "the children" (letters, 6 June).

But whose children are they? Ours? Yours? What about the children used by drug dealers as part of their illicit business infrastructure? Or, the children caught in the cross-fire of drug-fuelled gang violence for control of territory? Maybe, they're orphans of the more than 28,000 Mexicans who've been killed in the "war on drugs" since 2006?

They could be the children who've lost siblings to the variable quality, and lack of quality control, of illicitly supplied drugs; not just impure drugs cut with strychnine or arsenic, but too much purity, leading to unintentional overdose.

The "war on drugs" has been a gross failure, and must be abandoned. It is time to develop a humane policy that reduces harm to society and the individual, and eradicates the violence, corruption and societal damage caused by the criminalisation of drugs.

Barry Richards

Cardiff

I pay 20 per cent VAT when I purchase my lawnmower but no VAT on my cannabis. I pay enormous excise taxes on petrol and cigarettes but my heroin is duty-free.

Decriminalisation will not put this right. Legalisation will. The Government should begin work immediately to consider the huge complications of legalisation and how drugs should be regulated and taxed.

Vernon frost

London N21

In our interest to give overseas aid

I welcome the fact that the Government has ring-fenced overseas aid from the cuts, and am proud that in comparison with many other governments we have actually stood by our promises.

How many of those who disagree with this position, even our poorest citizens, are having to live on the equivalent of one dollar a day or have no ready access to clean drinking-water? How many people in Britain have to walk many miles to a hospital only to receive very limited help when they arrive (or perhaps no care at all if they have no money or the hospital has run out of drugs)?

Promoting global prosperity is not just a moral imperative but also firmly in Britain's national interest; if we do not tackle the root causes of poverty we will spend much more time and money in future trying to deal with the symptoms.

At the same time we need to monitor more closely how aid is used, we need to help developing countries by promoting fair trade not dumping subsidised surpluses on them, channelling more of the aid through NGOs, and, yes, being most generous with those countries respecting human rights and practising responsible stewardship of their natural environment.

John Wainwright

Potters Bar, Hertfordshire

David Cameron is quite right: we can keep up our foreign aid commitments despite being in debt. And here's how: stop spending billions on weapons we do not need to defend this country, and stop sending British forces off on expensive military adventures involving states that do not pose any threat to us.

An added bonus will be that not waging war in other people's countries will help prevent those people from dropping into the dire poverty of refugee status.

Lesley Docksey

Buckland Newton, Dorset

Of course we should continue to give overseas aid and even increase it (letters, 31 May).

We are an affluent country for whom problems related to overweight and obesity – largely a consequence of collective over-indulgence and indolence – cost the NHS £4.3bn a year and the national economy £16bn. And we think we can't afford a few bob to help people who don't know where their next half-bowl of rice is coming from?

Francis Kirkham

Crediton, Devon

Flat-rate rail fare would cost more

Lee Pickering (letter, 30 May) suggests that a distance-based fixed fare would simplify rail fares. It would, but fares would rise substantially because the discounted advance fares which help to manage the yield on the railway would be swept away.

As stationmaster of one of the UK's few independent stations, I have seen simplification used as an excuse by the train operating companies to push customers up to the next pricing level, which is hardly passenger-friendly.

Seats on passenger trains are a scarce resource, where there is sometimes overcrowding and other times trains run with plenty of empty seats. Does it not make sense to offer discounted travel opportunities at less busy times?

On our East Coast Main Line the difference between the cheapest advance standard class single from Chester-le-Street to London at £13.50 (restricted to a particular train with a reserved seat) and a flexible full-fare first-class ticket is £193, a multiple of more than 14. If everybody was to pay the same price is would be much higher than many people are now paying.

There are many ways to reduce rail fares. Get a railcard if you are spending over £84 in an entire year, book 10 to 12 weeks in advance for the best fares, avoid Fridays, and be flexible in your travel time. Don't ignore first-class fares – it's amazing how often people booking standard class fares on-line leave cheaper first- class fares unsold.

Alex Nelson

Chester-le-Street, Co Durham

Drake had time to finish game

Can anyone explain why it seems now de rigueur to query the story of Drake finishing his game of bowls before sailing to meet the Armada ("Drake's game under threat", 3 June)?

As any one who has studied the situation at sea when he received the message of the Armada's approach knows, to have put to sea immediately would have been an invitation to defeat. Strategic considerations demanded he wait a considerable time for the tide to ebb to gain a chance to take the weather gauge and defeat the enemy.

He also had a considerable body of seamen kicking their heels, wondering why the delay. What better way to keep the confidence of his fleet than to say something very similar to his alleged words? There may be no absolute proof of his precise words but that something very similar took place must have a probability well into the 90 per cent region.

Richard James Snell

Chippenham, Wiltshire

Message of hope for an email geek

I was intrigued to read Tim Pyne's letter about life without a computer, this morning (2 June), as I sit in the coffee shop with my laptop and mobile phone working away, probably annoying the living daylights out of my own staff with my emails.

The advent of "always on" has changed how we all behave dramatically. I find myself responding to emails at 11 o'clock at night, usually to the detriment of all concerned, and most of my time irritated because the politics of work now infiltrate my life at all times.

As a head of information systems and a self-confessed "geek", throwing things away may well be beyond me. Perhaps it is time to move to "always off". Thank you Mr Pyne.

Laura Dawson

Sandy, Bedfordshire

Olympic victory

We bid for just over £900 worth of Olympic tickets, and have received about one-third of what we asked for (letters, 6 June). You cannot judge from the very limited anecdotal evidence of friends and/or colleagues, nor from newspaper headlines, how the tickets have been distributed. I await the inevitable statistical analyses with considerable interest, but before then all the talk is simply that – talk.

Andrew Kelly

Ilkley, West Yorkshire

Painful memory

Sorry Charles Nevin (6 June) but "Only the Lonely" was issued 51 years ago, not 61. I know because I was 21 and had just split up with my girlfriend, and played it constantly.

Patrick Cleary

Honiton Devon

Perspectives on the Arab Spring

An impossible dilemma in Libya

Now that Britain has deployed ground-attack Apache helicopters in Libya, it's obvious that the policy is now one of regime change and the removal of Gaddafi, rather than protecting civilians.

This is not based on any rational political objective but rather to avoid addressing the numerous contradictions and double-standards as to why the UK is intervening in Libya when other state dictatorships such as Bahrain and Yemen are being equally repressive.

These regimes were never communist but right-wing neoliberal dictatorships which were fully backed up by the US and the UK, who regarded the lack of democracy and their dictatorial status as a mere secondary issue, shedding crocodile tears now and again when it suited them.

Quite apart from exploiting the demonic spectre of Gaddafi that has been conjured up for years by the western media, the real reason for the intervention in Libya is not primarily to support the democratic demands of the protesters but to ensure that the economic status quo remains, regardless of who leads it or whether it is democratic or not.

The dilemma confronting US and UK political and military leaders is how to preserve the economic status quo while being seen on the world stage as staunch defenders of freedom and democracy. The more they fail to do this the more aggressive will military intervention in Libya be.

Nick Vinehill

Snettisham, Norfolk

Autocrats do not want reforms

The letter (2 June) from Robin Lamb, former ambassador, headed "Bahrain leader wanted reforms" was a blinder by the Foreign and Commonwealth Office old boys. The ruler and his family are autocrats. If they wanted reform, what stopped them?

Was it Saudi Arabia, another bunch of autocrats, who have financed unrest across Africa, 9/11 and al-Qa'ida and provided the iron fist that will keep the Khalifas in power, while blaming Iran. Or perhaps self-interest? The UK, if being represented by friends of autocrats, is in for a real wake-up call when the "Arab Spring" reaches Saudi Arabia.

Peter Downey

Bath

Why the despots blamed Israel

The Baathist regime in Syria has sunk to unprecedented levels of moral bankruptcy. Nothing could illustrate this more than the gruesome piles of bodies in the streets.

Despotic regimes across the Middle East have always exploited the Arab-Israeli conflict to divert attention from the more fundamental challenges in their midst: foreign debts, unemployment surges among the youth, high-level corruption and glaring poverty among the masses.

As a European diplomat eloquently put it: "The Arab Spring is the best thing that has happened in my lifetime in the Arab world." It is an uprising against states-sponsored terrorism; against social and economic orders that had suffocated the aspirations of the people for democracy, human rights, liberties and pluralism.

Munjed Farid Al-Qutob

London NW10

Bombers and racing cars – what next?

This country's response to the "Arab Spring" is so excitingly varied. First we send bombers to hurry one dictator to the exit, then racing cars to keep another one home and dry, with international image boosted. What's next? Bikes? Wheelie bins? And to boost or bust?

Better hurry before we run out of venues. Yemen already seems to have managed without our spectaculars.

Claudia Cotton

London N7

Join our commenting forum

Join thought-provoking conversations, follow other Independent readers and see their replies

Comments

Thank you for registering

Please refresh the page or navigate to another page on the site to be automatically logged inPlease refresh your browser to be logged in