Letters: Cycle safety

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Mass use of helmets has never made cycling safer

Sir: Contrary to popular myth, cycling is not a "dangerous" mode of transport (Motoring, 21 November). The actual risk in cycling falls within the bracket of experience for pedestrians and drivers. Cyclists do not have to wear helmets, not until pedestrians and those in cars begin to.

This point alone destroys the case for promoting helmets, let alone making them compulsory. The "danger" myth comes from the hysteria that pervades cycling in countries where it is a minority pursuit. The more popular cycling is, the less popular helmets are.

More cycling means safer cycling, but less cycling increases the risk per cyclist. For instance, experience in London has shown that road casualties did not increase as cycling increased, implying falling risk per cyclist. This is a ubiquitous outcome. Promoting cycling reduces risk, reduces road danger to pedestrians and greatly benefits public health; therefore it should be done.

Mass helmet use has never made cycling safer. Countries that have strongly promoted helmets, or made them compulsory, all show the same outcome; a fall in cycle use but no sign at the population level that (serious) head injuries were being prevented. Falls in the numbers of head injuries are always explained by reductions in cycling or wider road safety policies that reduced all road deaths and injuries (the helmet law in Victoria, Australia, is a case in point). Unless I am to understand that telling people smoking is dangerous will encourage them to do it, I rather doubt that helmet programmes will ever have a different effect. Less cycling means more risk per cyclist.

The above points have been repeated many times in the past six years, and also have appeared in many reputable medical journals.



Father suffered in the same hospital

Sir: The shocking and moving diary by Patricia Balson (Extra, 16 November) reminded me vividly of the appalling treatment suffered by my dying father two years ago when admitted to the same hospital.

He was admitted from the residential home where he was living when he was taken ill. My brother and I were abroad on holiday, so my daughter rushed over from Cheltenham.

For two days, she found it impossible to find out what was happening to him as he was moved from ward to ward. Having eventually established that he would not be discharged for two or three days, she told staff she was going home to collect her clothes.

Within an hour of her leaving, the hospital tried to ring her to tell her our father was going to be discharged immediately. Having been unable to speak to her, the hospital then put our father (who was very sick and confused) into a taxi and sent him back to the residential home alone. The home was not contacted and staff were amazed when he turned up.

There were other issues, including the awful state of the ward and the thoughtless treatment of my father. What has happened to patient care?



Sir: Janet Street-Porter's sister's experience belongs in a different century and I couldn't agree more about the need to end mixed-sex wards, but I think it goes beyond that.

I was in John Radcliffe Hospital, Oxford, with a skin infection. When I was told I needed admission, I asked if I could pay for a private room. Yes, I could, but only if I paid for private medical provision also.

Is it such an unreasonable aspiration when sick to have privacy, and perhaps a little more comfort, especially when willing to pay for it? The NHS, just like other public services, is failing to deliver choice, and failing to treat us as the paying customers we are. Perhaps the state is afraid that, if we pay, we might demand quality and choice as well.



Sir: Patricia Balsom's diary (16 November) was a powerfully insightful account of the poor level of care she had from a particular NHS trust and these problems must be addressed and those local practices changed.

The headline stated that these problems are "engulfing" the NHS, but this is not necessarily the case. As a patient who had the best care from the team at a teaching hospital in Sheffield for the past 11 years, I must redress the balance.

From that first encounter, through investigations, radiotherapy, subsequent appointments and recent stay in hospital for radical surgery I have had the best clinical, physical and emotional care and support. I have always felt confident in the clinical decisions that had to be made, having been treated with kindness, dignity, respect and honesty. This level of care continues to be delivered by my GP and district nursing service at home.

Yes, patients and relatives must complain when anything less than best is delivered and managers must listen, learn and instigate effective change. But examples of best care should also be highlighted and those individuals involved regarded with the esteem they deserve. In my case, the 200-mile round journey to be treated by this team of expert clinicians is more than worth it.



Sir: Bureaucracy may make the lives of terminally ill patients worse (Letters, 20 November), but the real problem is macho scientific medicine, which sees death as the ultimate enemy, to be defeated on behalf of the patient. After a person has been told they have only a short time to live, that pattern of thinking is no longer helpful. Rather, at that point we need to go back to the more ancient notion of the doctor as healer of the whole person.

Science has done a lot for human health. But as we are all going to die eventually, all of us would benefit from our doctors reading Elisabeth Kubler-Ross's book On Death and Dying, which says: "Death belongs to life as birth does." Patients facing death need emotional help.

Proper care of the dying needs to deal with the human spirit as well as physical illness. It's hard to get it on to the balance sheet, but modern science needs to make itself a partner of ancient wisdom.



It's not the killing, it's the pain and terror

Sir: Your leading article ("Ill-conceived and unenforceable", 20 November) and the distressing accounts of law-breaking by hunts deserves comment.

Despite the huge campaign of misinformation and blatant lies from the Countryside Alliance, most people in the UK remain strongly against needless cruelty to animals. Second, the Hunting Act is not about not killing foxes. We kill millions of animals for food each year. The Act is about not doing it in a way that seems designed to inflict the most terrifying, excruciating and painful death upon a wild animal for no better reason than that it's fun.

Third, if this law, which has huge support, is being ignored by the police, it is up to all concerned citizens to hold their local chief constables to account; you decide their priorities, not them.



Sir: Like 1970s trade union bosses, the huntsmen interviewed by The Independent clearly believe only little people obey the law. That's all the more reason for the rest of us to insist the law is enforced by the police, particularly since even in the countryside itself only 36 per cent of people oppose the hunting ban and 33 per cent support it (BBC opinion poll, January 2005).

This is not the countryside against the town, but an arrogant well-connected minority determined to ignore parliamentary democracy.


Arabs get chance to prove ownership

Sir: What your article "Palestinians 'own 40 per cent' of Israeli West Bank settlements" (22 November) does not indicate is that the private property referred to was unclaimed privately owned land.

Since 1977, the Israeli government has mandated that any private Arab claimant of land slated for Jewish construction has the right to stake such a claim in the Israel high court of justice.

Most privately registered land inside the Jewish communities of Judea and Samaria has never been claimed or challenged.

But in Efrat, just south of Bethlehem, Jewish families slated to move there in 1979 were prevented by the high court from doing so until 1983, only after all Arab claimants had their opportunity to go to court to prove ownership of privately owned lands.

The court eventually ruled that several tracts of agricultural land inside Efrat are owned by Arabs, and these tracts are tilled by their Arab landowners to this day.



Church does not support euthanasia

Sir: In response to letters about the Nuffield Council's recent report (22 November), I wish to emphasise that the Church of England does not support euthanasia.

There is a clear distinction between interventions which are deliberately aimed at killing, and decisions to withhold or withdraw medical treatment when it is judged to be futile or burdensome. This is equally valid for all, including fetuses, newborns or the elderly.

The Church's submission to the Nuffield Council's consultation, made in June 2005, restated this resolute opposition to euthanasia, based on the understanding that every life is loved and valued by God equally. It was also entirely consistent with our long-standing policy on treatment at the beginning and end of life.

We therefore welcomed the Nuffield report's clear recommendation that "the active ending of life of newborn babies should not be allowed, no matter how serious their condition".

But we oppose their blanket recommendation about the treatment of babies below 22 weeks' gestation. These decisions should always be made on an individual basis.



Sir: How dare Dominic Lawson say, on little or no evidence, "those who pretend that their peculiar loathing of the most vulnerable of all children is no more than a disinterested desire to see the NHS's funds allocated for the benefit of all" (Opinion, 14 November).

He does not know the motives of those who support euthanasia for severely disabled babies, but he may accept that they have several grounds to consider which have nothing to do with loathing the disabled.

For example, if (as the majority accept) it is morally acceptable to abort a foetus because it has Down's syndrome or because the mother simply doesn't want to give birth, may it also be acceptable to destroy a baby that was little older and had far less chance of a healthy or happy life?

Doctors didn't ask anyone before they started keeping very premature or disabled babies alive, and it's about time they did consult the public.

The majority view really is that disabled lives are generally less enjoyable and full (this is not any criticism of the disabled). That is why we banned Thalidomide and would ban any other drug that might cause disability.

NHS funds, and all public funds, are limited, and the people (not just individual parents) ought to have a say in how they are used.



What a sauce

Sir: Never mind Marmite, pasties and anything else. My investigations into the date when the label on the Daddie's (sic) Sauce bottle became Daddy's (sic) Sauce, although worthy of Lynne Truss, has yet to be cracked. Even the makers can't tell me. Who can?



Down to earth

Sir: Anyone who believes expansion of air travel will continue indefinitely is in cloud-cuckoo land, or near by. All credible expert opinion suggests global oil production will peak in 2010 but global demand will continue to rise, fuelled by high-growth economies. The laws of supply and demand dictate significant oil price rises with concomitant inflation in all dependent goods and services, and possible global recession. Either way, the luxury of cheap, mass air-travel will be an historical anomaly. The Strategic Aviation Special Interest Group need not worry; no UK airport will add a new runway after 2010.



Good and bad

Sir: Let us get things into perspective about opera (Letters, 22 November). Puccini's Madam Butterfly is one of the greatest operas of the 20th century. Beautiful music. Interesting storyline (Puccini certainly knew how to pull at the heartstrings). I like musicals too so I went to hear Les Miserables; to be honest, it was pretty miserables. The whole experience was bland. I do not think its a case of being a snob but rather knowing what is really good from bad.



Wrong monarch

Sir: George VI was not "the Queen Mother's father-in-law" (Extra, 22 November). The bearded bust on Prince Charles' desk is obviously that of the true father-in-law of the Queen Mother, King George V.



Stumped by comma

Sir: A meaning~changing comma has crept into Angus Fraser's article (Sport, 22 November). The Adelaide Oval has short square boundaries, not "short, square boundaries". Silly point?



Don't stop shopping

Sir: Andrew Brown tells us that the Church Commissioners for England have a fiduciary duty to maximise returns from investments (Letters, 22 November). It might be best, therefore, that his colleagues didn't risk undoing his good work, by deterring those who wish to spend their money at the Metro Centre unbothered by preachers in the malls.



Affluent effluent

Sir: It is worrying to read that London's Olympic costs include £145m for sewage ("The big question", 23 November). Much better to spend the money on sewerage, to carry the effluent away.