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Letters: GPs' role

GPs are cautious but not unwilling to do minor operations

Monday 12 February 2007 01:00 GMT
Comments

Sir: In response to the "radical" proposals to carry out some minor operations in the community, you assume that doctors will object on the grounds of extra workload and cost ("A surgical solution", 6 February).

Those with slightly longer memories will recall that many operations were enthusiastically carried out by GPs in the early days of the NHS. With the demise of cottage hospitals, this has become a rarity. Few GP premises have the space for a properly equipped operating theatre. This will be the main stumbling block.

The proposal has merits, particularly in respect of infection control. However, it won't save on hospital beds as the procedures mentioned are already done as day cases. Nor will it free up consultants as they will still, in the main, be doing the operating - certainly I would hope that to be the case for removing cataracts.

Whether it saves money remains to be seen. There is a real danger that supply induced demand will increase the number of non-essential operations leading to an increase in costs. There will be knock-on effects on the finances of local hospitals who can ill-afford to lose the income they currently receive for day case surgery.

As with all new policies, doctors will ask for the evidence to support a change because it's the way we've been trained to think. You wrongly represent this cautious approach as self interest or concern about our workload. In spite of changes to out-of-hours arrangements, GPs still work about 50 hours a week. Most of us spent our working lives doing another 20-30 hours a week on call, so you can't say we worry about workload.

We are well paid, but I don't think this is out of line with the earnings of other professionals who have undergone a long training to do a responsible and pressured job.

DR CHRIS PRICE

NORWICH

Branson's quick fix is not the answer

Sir: Richard Branson appears genuinely concerned about the future of the planet when he offers a £10m prize for the person who finds an effective way of absorbing excessive atmospheric carbon dioxide (9 February). However, it seems very unlikely given millions of years of evolution, that a more cost effective process for soaking up CO2 will be found than that used by the plant leaf. All the inventive scientists and technologists put together will not better a self building structure that uses free and clean energy while effortlessly capturing carbon at it does so.

So, Mr Branson, I put my pitch in first for the £10m prize. My invention would be to plant trees and let them soak up the carbon. Furthermore, I would use the wood for building homes. The brilliance of my invention is three fold: 1) Trees grow themselves, so there is no need to pay the costs of production or transportation of materials. 2) Wood, with its captured carbon inside, is a warm and sympathetic material with which to build homes and it saves on CO2 otherwise needed to make and carry bricks or cement. 3) Extra habitat is created for wildlife and recreational space for people.

What is urgent, Mr Branson, is the need for you to focus your popularising talent on getting the real and known solutions to climate change across to a wider audience. If we are to educate our children in the science of climate change we need allies in the business world to work with us.

We need to move away from popular hopes for easy "quick fixes". Huge quantities of CO2 cannot be simply removed from the air as the oceans of the world warm up. The true remedies will require long-term international initiatives to ensure that the polluter pays. Only when carbon users pay for the CO2 pollution they cause will ideas for alternative energy become economically realistic.

When that happens we really can look forward to the day when Virgin trains and planes travel with a clean conscience.

BENJAMIN COLLINS

SCIENCE TEACHER, LEICESTER

Sir: Richard Branson's acknowledgement of global warning and the damage we are doing to our environment is admirable, but his refusal to accept the answer is itself the reason for global warming. The only solution is to reduce consumption.

We need strategies in place to promote less travel. For example, businesses could encourage company\industry wide "work from home days", massively reducing carbon emissions generated by the 45-minute average commute. More needs to be done to foster markets for local "modern" businesses, for example, all IT or telecommunication contracts should have to be submitted to a local market before looking elsewhere globally.

ROB DUNFEY

EDINBURGH

Sir: If Sir Richard spent his £10m on a carbon-free jet engine, he might feel a little less guilty, and I might feel a little more inclined to fly Virgin.

DR TIM LAWSON

CHEAM, SURREY

Oxfam's stance on British supermarkets

Sir: It was a complicated and difficult decision to turn down Mr Walston's innovative proposal ("I should never have offered farm aid to Africa", 6 February). We appreciate his offer and are keen to work with British farmers to address some of the problems that their counterparts overseas face.

Perhaps the best place to start would be for them to support meaningful reform of the Common Agricultural Policy. This encourages overproduction and dumping, and along with other unfair trade rules, is a major cause of poverty in the developing world.

We had to decline Mr Walston's offer, which would have involved fundrasing with supermarkets, because we have ongoing campaign work on the negative impact of retailers' behaviour on poor people in the developing world. Our donations policy dictates that we cannot accept money from people, companies or organisations against which we are campaigning. We feel it would be hypocritical, counter-productive and potentially compromising to do so. This policy applies across our campaigns and has led to us turning down money from a number of sources.

By demanding suppliers deliver goods ever cheaper, faster and more flexibly, Britain's leading supermarkets are contributing to appalling working conditions for women and men in factories across the developing world, and helping to push small-scale farmers off the land as production intensifies. British farmers are probably also all too familiar with the capacity of British supermarkets to use their market power to squeeze suppliers.

We are by no means closed to the idea of ever working with supermarkets - on the contrary, we are engaged in a dialogue with all the major chains to look at ways to change their practices and lessen the negative impacts. We could also accept their money if they passed our rigorous ethical screening process.

However, entering into a fundraising initiative which included all the big names is something that we feel we cannot do at this stage.

BARBARA STOCKING

DIRECTOR OF OXFAM OXFORD

Differing opinions in Jewish community

Sir: Vivien Simenoff (letter, 7 February) boldly dismisses as "a tiny minority with limited knowledge of the real situation" all those Jews who challenge the false image of a community solidly behind Israel whatever it does, which the Board of Deputies of British Jews assiduously projects. I don't know where she gets her certainty, perhaps from herself and her friends.

The reality is just as the new group, Independent Jewish Voices, say. This is proved by the excellent survey into Jewish identity conducted in spring 2004 for the United Jewish Israel Appeal, one of the major Jewish charities in the UK.

Opinion among British Jews about the Israeli-Palestinian conflict was as widely distributed in any other group of people. In fact, opinion was skewed against the Israeli government. The survey showed that 31 per cent of those surveyed were often critical of Israeli government policies, 47 per cent were uncertain of what to think, and only 22 per cent were generally supportive.

The survey also showed that 78 per cent "care deeply" about Israel, which makes the diversity of opinion all the more important.

We are a mature community. Our differences of opinion are healthy. The wider community and the political establishment should be aware of this.

ARTHUR GOODMAN

PARLIAMENTARY LIAISON ORGANISER, JEWS FOR JUSTICE FOR PALESTINIANS LONDON

Dissension over EU constitution

Sir: Richard Corbett's letter (10 February) shows just the kind of arrogance which Eurosceptics abhor in pro-EU politicians.

He claims that two-thirds of EU countries have ratified the proposed constitution. So what? It was clear to everybody from the beginning that total unanimity was required. The EU, whatever its nomenklature might wish, is not a sovereign state, and treaty adjustments require consent from everybody.

Pointing out that only two have rejected it is disingenuous; since it was rejected by the French and Dutch, other countries, such as our own, have not been given the chance. The very fact that the British people have not been allowed to express their opinions in a referendum leaves little doubt as to what our rulers believe the verdict would be.

ALEX SWANSON

MILTON KEYNES

Sir: Richard Corbett MEP is absolutely right. It is essential to have a new EU treaty, along the lines of the Giscard constitution, to enable the decision-making process to work.

There will always be voices claiming that there are more important things on the agenda than fiddling about with the rules, which should therefore be put off to another day. But sooner or later an eminently sensible policy proposal, perhaps on climate change or terrorism, will be blocked because a small country will veto it due to some domestic political problem, and even UKIP will then be complaining. The extension of qualified majority voting, with proper weighting given to all 27 member states, cannot wait much longer.

ALAN PAVELIN

CHISLEHURST, KENT

Wrathful revenge of Wagner's widow

Sir: Although the article about Himmler and the Holy Grail (6 February), was very interesting, there was one false piece of information. The first performance of Wagner's Parsifal was not in Barcelona in 1913, but at Wagner's own opera house at Bayreuth in 1882. Indeed, performances of the work in any other place (other than in concert) were expressly forbidden by Wagner (and enforced by copyright) for many years after his death in 1883, because it was considered inappropriate for this "sacred" drama to be seen anywhere apart from Bayreuth.

This embargo was eventually broken in 1903 when the Metropolitan Opera in New York braved the wrath of Wagner's widow and staged its own production. Frau Wagner was not impressed and rewarded this treachery by banning the lead singers from Bayreuth where they had previously appeared.

JOHN MACKEONIS

LONDON W6

Cameron's conduct

Sir: Tony Blair and his government and almost all the population, will read David Cameron's admission that he occasionally used cannabis whilst a student, and almost all will sympathise and none will make capital of it, which of course places the entire matter into perspective. It's not every member of parliament that can admit to certain indiscretions and I for one feel somewhat happier to vote for Cameron knowing that he appears relatively normal, warts and all.

CHARLES HOLCOMBE

BRIGHTON

Sir: So Mr Cameron smoked marijuana at the age of 15. Does that make him unfit to be Prime Minister? I am sure many MPs have had the odd reefer or two. While he was having this illegal drug, at the age of 15, was he thinking about being Prime Minister, I don't think so. Bill Clinton admitted smoking, but not inhaling, George Bush was a drinker, but this didn't prevent either of them from becoming president of the world's only superpower.

ROBERT PALLISTER

PUNCHBOWL, NSW, AUSTRALIA

Turkey truths

Sir: We need to know what is a "semi-processed" turkey (report, 9 February). Does it have one foot in the gravy?

NICK ELAM

LONDON SE5

Sir: In answer to Joan Baines' quest (Letters, 10 February) for cheap nourishing protein as an alternative to factory-farmed poultry, why not try lentils and some of the wide variety of beans available at amazingly cheap prices, even for organic produce.

Vast numbers of tasty recipes are available and there is no need to cut out meat entirely if the idea of vegetarianism is too radical!

ANN BAXENDALE

SUTTON COLDFIELD, WEST MIDLANDS

Clear conscience

Sir: I drive my four-year old BMW X4 4WD about 9,000km each year. Is it more environmentally-friendly to buy a new Prius and allow another the opportunity to drive the gas-guzzler, or to keep driving it and save the environmental costs of constructing a new car? I think I can continue to drive the 4WD with a clear conscience.

ROY POUNDER

ITLAY, GLOUCESTERSHIRE

Criminal collection

Sir: Kenneth Wilson reminds us (Letters, 10 February) that as children we used to supplement our pocket money by collecting glass bottles and golf balls. This was positively encouraged during the Second World War. In 2007, recovering balls "lost" on a golf-course is classed as theft, and if Mr Wilson were tempted to do so today he would collect a criminal record along with the salvage.

TERRY EATON

MILTON UNDER WYCHWOOD, OXFORDSHIRE

It's snow big deal

Sir: What a fuss about the snow, as a lad in 1947, there were farms on the Lincolnshire wolds cut off for five weeks. At that time there were many more land workers. Many families had to kill and butcher the sheep just to stay alive! As a small boy, walking with my grandfather I was able to stand on a drift with one leg each side of the telephone wires. In some northerly facing ditches there were remains of drifts at Whitsun. It made us tough.

DAVID VINTER

LOUTH , LINCOLNSHIRE

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