Letters: GPs and NHS reform

GPs can run a health service

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Contrary to your editorial (27 May), it is not the case that most groups of GPs "have zero experience of management". In fact, most GPs own and operate their own practices in co-operative partnerships.

This requires them to manage them as businesses, managing contracts, staff, finances, premises, IT and external relationships with local authorities, secondary care and social services.

Indeed, since its inception, the unique genius of NHS general practice has been the healthy mixture of the business efficiencies of private-sector practice with the over-arching public service ideals of the NHS.

However, as your editorial recognises, it is foolish to pretend that efficiencies do not need to be made in the NHS.

The simple reality, painful to politicians and managers alike, is that the only plausible way of preserving the benefits of the NHS for future generations is to give some of the responsibility to the only group of people who have proven themselves to have the combined clinical and business expertise to do the job.

Dr Paul O'Reilly

Chair, Kensington, Chelsea and Westminster Local Medical Committee

London SW1

The Coalition's internal civil war over NHS reforms between the Orange pausers and the Tory "red liners" is threatening to tear this fast-fracturing government apart, along with the battered health service. The ill-starred Health and Social Care Bill has become not so much "a poll tax on wheels" as rail privatisation on a hospital trolley heading towards the nearest lift shaft. The only "red lines" that need to be drawn are diagonal ones across every page of the Bill in its present form.

Anthony Rodriguez

Staines, Middlesex

Lessons of Srebrenica

There are lessons to be learnt from Srebrenica after the arrest of Ratko Mladic, in addition to the usually cited ones. For instance, UN

Secretary-General Boutros Boutros-Ghali warned the Security Council of the folly of designating a safe area without sending sufficient troops to demilitarise it.

Srebrenica continued to be used as a springboard for Bosnian Muslim offensives. Appalling crimes were committed against civilians in surrounding Serb villages. Not surprisingly, Srebrenica was anything but safe.

Srebrenica was also a victim of a transatlantic dispute. Washington advocated air strikes but vetoed the use of US ground troops. Washington also wanted to call the shots. The Europeans were understandably reluctant to commit more ground troops. They also argued that air strikes imperiled vulnerable enclaves such as Srebrenica. The compromise was the despatch to Srebrenica of a token Dutch force. It became the prisoner of both the local Bosnian Muslim military and the surrounding Bosnian Serb forces.

Yugo Kovach

Winterborne Houghton, Dorset

Israel's place in a changing world

When Benjamin Netanyahu addressed the US Congress he said "Israel will not return to the indefensible boundaries of 1967" and "Jerusalem must remain the united capital of Israel," thus confiscating more land.

"Any peace deal must take into account the dramatic demographic changes that have occurred since 1967. The vast majority of the 650,000 Israelis who live beyond the 1967 line reside in neighbourhoods and suburbs of Jerusalem and greater Tel Aviv," thus confiscating more land.

He also called on Palestinians to see their future "homeland", rather that Israel, as the place to settle refugees from the 1948 war.

For this he received several standing ovations.

When President Obama addressed Parliament at Westminster he said that the UK and US had a continued responsibility to stand up for freedom, democracy and universal rights.

So while the US President declares the US stands for human rights, both houses of Congress loudly applaud the denial of these rights to the Palestinians.

William Garrett

Harrow, Middlesex

Netanyahu's defiance of Obama will allow Israel a few more years of refusing to face the fact that the status quo cannot remain if Israel is to have a future. Its existence is at threat from three fronts: the US losing its position as the world's superpower, the demographic time bomb and the Arab Spring.

The US's defence budget is being reduced. It will have neither the world stature nor the funds to provide Israel with political cover or to finance to its defence; the $3bn in annual defence aid will have to end.

The Jewish population of Israel, east Jerusalem and the West Bank is approximately 6.2 million, the Palestinian population about 5 million. The annual birth-rate of the Jewish population being about 15 per 1,000, and the Palestinian 30 per 1,000, by the 2020s the Palestinian population will equal or exceed the Jewish.

The Arab Spring has just started and no one knows when it will end. However one thing is certain: the new governments will not have the same relationship with the US and Israel as the old ones. The Arab Spring will be a curse to Israel unless it allows the creation of a viable Palestinian State.

If Netanyahu refuses to negotiate from Israel's current position of strength, his successors will curse him as they are forced to negotiate the creation of a Palestinian state without the support of the US, and with a hostile Palestinian majority demanding the same political freedoms which had been obtained by their Arab brothers in the Arab Spring.

George D Lewis

Brackley,Northamptonshire

I was happy to read in Trevor Johnson's letter (26 May) that he realises Israel is not an apartheid state – and indeed, Muslims, Christians and Druze are not discriminated against when voting for the parliament.

I am also happy to refute his claim regarding no Muslim, Druze or Christian serving as ambassador, or in a high-ranking position. In the Israeli Ministry of Foreign Affairs there are people from all walks of life, regardless of their religion. Druze, Muslims and Christians have served as ambassadors to Geneva, Bogota, Athens and elsewhere.

This is in line with Arabic being Israel's second official language, as well as minorities serving in the military, police, parliament, in the Supreme Court, as ministers, in the media, and so forth.

Amir Ofek

Counsellor for Media Affairs

Embassy of Israel, London W8

'Rubbish at maths'

Thank you to Professor Brian Butterworth, who has called for greater awareness of dyscalculia (report, 27 May).

It is hard to imagine the stigma that sufferers feel because they are considered, and consider themselves, to be "rubbish at maths".

A classic example is my partner, who for a long time suffered a massive lack of confidence because of her problems with maths – despite being a highly intelligent graduate; it was only when a tutor at university suggested that she might have dyscalculia and tested her that she realised that she was not "stupid". Unfortunately, this took place when she was 45 – years were wasted feeling this way. She is now getting tutoring with a specialist adult education teacher.

We are now going through similar problems trying to get our son tested, but dyscalculia is not a truly recognised special education need, so testing is very difficult to come by.

Professor Butterworth and his colleagues are right. This problem is not taken seriously.

Adam Costello

West Kirby, Merseyside

Scotland's ethnic cleansing

Now that the Queen has acknowledged the wrongs done to Irish people, can we expect any time soon a similar recognition for the ethnic cleansing of the Highlands and Islands during the Clearances?

The evictions lasted for more than 100 years and many of the tyrannical landlords and clan chiefs were sitting members in the House of Commons or the House of Lords. The expulsion of the people was in many instances perpetrated by landlords who had been knighted by the Royal Family.

My ancestors were evicted and landed in a dense Canadian forest having survived a tempestuous Atlantic voyage. Do we not merit an apology, or are we in the eyes of the British establishment less worthy than the Irish?

Donald J MacLeod

Aberdeen

Wrong words

The Chief Executive of Worcestershire Acute Hospitals refers to findings of neglect of the elderly as a "wake-up call". The NSPCC uses the same phrase in response to a rise in cases of child abuse. Perhaps if these and related organisations avoided such clichés, they and we might remember that neglect of the elderly is a disgrace and that child abuse is appalling. A start would be the banning of the word "inappropriate" in these contexts.

Louise Amor

Loughborough, Leicestershire

Free at last

Oops, Julie Burchill (26 May). It was not Socrates but the poet Sophocles who is alleged (by Plato in The Republic) to have equated the fading of his sex drive with the achievement of release from "the clutches of that savage and fierce master" (A D Lindsay translation).

Marcus Wheeler

Belfast

Perspectives on banking

Big payouts voted through

It appears that the public are more interested in what the bankers do in the bedroom than in the boardroom.

Last week I attended the AGM of Lloyds Bank, which now incorporates Halifax and TSB, in order to urge shareholders to vote against the remuneration report of executive salaries for the year. I drew attention to the fact that millions of people are being affected by the financial crisis due to bankers' actions. Most of these people are paid less than a fiftieth of what top bankers get.

Unfortunately the 2,798,317 small shareholders holding less than 1,000 shares who make up 81.2 per cent of the total shareholders, hold only 1.03 per cent of the shares. The top 0.04 per cent, 1,108 shareholders in total, control 94.33 per cent, and so were able to approve the payouts.

It is scandalous that having bailed out the banks with public money , the Government, who own on our behalf 41 per cent of the shares, actually voted in favour of these payouts, despite all they have said about the need to curb bank bonuses.

Instead of the Government controlling the banks, the banks apparently control government.

The Rev Dennis Lloyd Nadin

Harlow, Essex

Honest hard work

K Hall (letter, 21 May) suggests something close to "banker" as the male equivalent of "slut" or "slapper".

Does K Hall not realise that there are many female bankers as well as male? There were women on the boards of RBS and HBoS when they collapsed – and of Lloyds TSB when Gordon Brown snared it into taking over HBoS.

As a retired banker, I know that the vast majority of the thousands of bankers in this country, whether male or female, are honourable, hardworking and modestly remunerated. My colleagues and I worked hard over decades to ensure the safety and propriety of Lloyds TSB's lending and operations.

Most of us were appalled at the disastrous decision of the board, a small group of overpaid people of both genders at the top of the bank, to take over HBoS.

C R Richardson

South Gloucstershire

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