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Monday 23 May 2011
Letters: Health reforms
Is this a slow death for NHS?
Maybe it's me, but I have noticed a change of late in the strength of opposition to the health reforms in the letters pages of your newspaper and some others. Is this because the Coalition is doing a good selling job, or are vested interests coming out of the woodwork?
The head of health at the accountancy firm KPMG, Mark Britnell, a prominent member of Cameron's so-called "Kitchen Cabinet" on health reform, blew the whole thing wide open when he told a conference of executives from the private sector that future reforms would show "no mercy" to the NHS and would offer "big opportunity" to the for-profit sector.
I'd say these remarks show all we need to know about the motives of these reforms. We seem to be sleepwalking into the NHS's demise.
Sir Michael Rawlins raises important points ("NHS chiefs 'care more about costs than lives'", 20 May) about patients not being offered new medicines and the chance to help in research, and the Health Bill in its present form will make this worse.
There are already significant problems with PCT commissioners not giving patients access to new drugs despite the legal authority given to NICE to determine what should be made available.
Yet the Bill will remove this power from NICE altogether, leaving patients at the mercy of their GP commissioning groups and what they decide to make available. This will lead to a huge increase in the postcode lottery for drugs, with no legal redress for patients, as well as patients transferring from one GP to another simply to gain access to the right medicines.
GPs don't want this responsibility and it will increase health inequalities and waiting times as patients move to areas that prescribe what they need. Added to this, drug trials depend on being able to compare a new product with the existing "best in class". If patients are not being given the best available, they can't take part in a trial. This damages both health and the economy.
Amid all the debate about who should be on boards and denial of the importance of competition, if patients can't get the medicines they need, haven't we lost sight of what the NHS is for?
Chief Executive, 2020health.org,
Dr Stephen Black (letters, 19 May) says that reform of the NHS must be pursued regardless of the objections of hospital consultants, and claims that "it is vital that the power of incumbent lobbies is broken and that we put investment decisions in the hands of those who will put the interests of patients before the interests of powerful lobbies". He seems to suffer from the same myopia as many of our politicians, whereby vested interests and selfish lobbyists exist only in the public sector.
What I find far more worrying is the extent to which governments seem to be in thrall to the vested interests and lobbying of "the City" and big business. Repeatedly, we read that proposed reforms have been diluted or abandoned because of special pleading, or threats, by bankers and business leaders, whereupon elected politicians cave in. Professionals in the public sector seem to the the only people whose views are not listened to and whose expertise is routinely denigrated.
The real threat to the NHS is posed by private health companies who are circling like vultures, licking their lips at the potential profits to be made from a privatised health service. Of course, these are not defined as vested interests.
Dr Pete Dorey
Reader in British Politics,
We should grade sex crimes
Surely it is time to divide sex crime into two categories (letters, 21 May). Rape, for what Ken Clarke described as the more serious cases, and the crime of "sex without consent", or some such wording, for crimes such as date-rape.
There are obviously grey areas but these are not dissimilar to the grey areas between murder and manslaughter and the Law manages to deal with these. It may also have the advantage of increasing the conviction rate.
For anyone to suggest that being brutally attacked, often by a stranger, forced into obscene acts with the threat of further violence or death is no more serious than being forced to have sex with someone that you have opted to go to bed with is an insult to the victims of such attacks.
Dallas Jane Brewis
What saddens me most about Ed Miliband's opportunist grab for headlines (report, 20 May) is not that he criticised Ken Clarke's inept and insensitive comments on sentences for rape, for which he has apologised, but because I so expected that he would herald a new kind of politics.
He stated when going for the Labour party leadership, "a lot of what [Clarke] is doing is motivated by budget cuts; but he is opening up an opportunity for us to redefine part of the debate about criminal justice." Alas, I fear New Labour's instincts for populist posturing on crime is still alive and kicking.
Taking my cue from the excellent piece by Christina Patterson (Comment, 19 May), I am off to my turf accountant to make an investment to the effect that Mr Miliband will lose his job before Mr Clarke loses his.
David Milsted (letters, 19 May) is wrong when he claims that there is any difference in law between a 17-year-old boy sleeping with his 15-year-old girlfriend and a 40-year-old man "persuading" a 13-year-old girl to have sex. As long as there is consent from both parties under English law these examples are the exact same crime; unlawful intercourse with a girl under the age of 16.
This is because under English law rape occurs only when a person has sex with another person without their consent; if there is mutual consent but one person cannot legally give consent because they are underage this is not rape but the less serious crime of unlawful intercourse.
Though had the girl in Mr Milsted's example been 12, rather than 13, this would have been unlawful intercourse with a girl under the age of 13 which carries a similar penalty to rape but is still not legally considered rape.
Cyclists don't play by rules
It was distressing to read that Malcolm Shepherd, the head of Sustrans, the cycling charity, had been knocked of his bike by a van (Report, 20 May). Presumably he had taken the precaution of wearing a helmet, unlike the cyclists I saw yesterday evening.
On a short car journey from Bexhill to Hastings I saw 21 cyclists. Eleven were riding on the pavement and eight were using the brilliant cycle path along the St Leonards/ Hastings promenade. None of these was wearing a helmet. Only two managed to get it "right", on the designated path and helmeted.
Surely if motorists are being asked to be more aware of cyclists they could at least help themselves a little by wearing helmets and being aware of where they are supposed to ride.
Bexhill on Sea, East Sussex
Obsessed with school leagues
Laurie Penny hits the nail on its head ("It's the exams that dumb us down", 19 May). I worked hard for both my GCSEs and A-Levels as a teenager and can completely appreciate the months of stress and pressure that students are put under, as well as how immensely difficult it can be to find work come the end of their education.
For years now, the huge schools machine has been less concerned with the actual students and more focused with their status in league tables, using children as pawns to achieve it irrespective of what is good for them or what their needs or ambitions are.
If our system of schooling was about individual development then we would not be seeing the spreading decrease in physical and creative activities.
Such activities develop well-rounded and intelligent children, but they don't always push a school up the league tables and neither, sadly, do many parents value them as part of an education.
Young people need more about them than exam results to make a life outside school. That seems to be why home-educated children do so well, because of their rounded, diverse and creative education.
And good luck to all those home-educated teenagers who will also be taking their GCSEs and A-levels this year. Funny how they never get a mention; perhaps folks feel too threatened by children succeeding even without the big school machine.
There is a road to the Inca city
Simon Tegel ("From lost city of the Incas to tourist trap in 100 years", 9 May) says that the fortress of Kuelap in northern Peru has no road access and requires a strenuous trek lasting several days to reach it.
I visited it when I was staying at Estancia El Chillo near Chachapoyas in September 2006, travelling with a guide in a Mitsubishi pick-up along unmetalled roads which were no deterrent to lorries carrying parties of schoolchildren to the site, which is almost 3,000m above sea-level, higher than Machu Picchu.
There is even a car park outside the gates to the fortress, which is mentioned in The Rough Guide to Peru, and a herd of llamas.
The journey from El Chillo lasted a couple of hours, but the main problem at the site was children climbing on the walls, largely because there were insufficient resources to fund an adequate number of custodians and provide the necessary notices and safety barriers.
Peru is yet to adopt a health and safety mentality and a culture which respects ancient monuments.
MOX is the clean way to the future
The opposition to MOX fuel overlooks the fact that we need to get rid of military plutonium from nuclear warheads (letters, 9 May). A significant proportion of US electricity is made from Russian warheads. The same technology can turn the Sellafield plutonium into carbon-free energy equivalent to 600 million tonnes of coal. But, given the record at Sellafield, maybe we should put the French in charge of the project.
MOX may be more expensive than mined uranium, but this will not remain true if there is an expansion of nuclear energy. Peak oil will soon present us with the choice of expanding nuclear energy or facing a medieval standard of living.
Plutonium, like many industrial materials, is very hazardous, but this hazard can be dealt with in an industrial context. Unfortunately, terrorists can find many domestic materials with which to wreak more havoc than they could if given a quantity of reactor plutonium which in any case would quickly kill them.
I use the word "given" advisedly because this is the only way terrorists could acquire plutonium.
Your letter-writer's contention that there is a clean, renewable alternative does not bear examination. Few could afford unsubsidised renewable energy, and the nation cannot afford to subsidise the amounts we need in a modern society.
The Japanese earthquake killed many people on trains and in houses. It is just as illogical to ban nuclear power because of the Japanese catastrophe as it would be to ban trains and houses.
Shipley, West Yorkshire
Beware of fire hazards
I imagine many a fire service manager will be weeping or raging at Phil Vickery's article (19 May) about fire in the countryside. I doubt they will be laughing. I was amazed at the poor timing and, frankly, at the stupidity of this.
We have had less than 10 per cent of our normal rainfall and several widespread forest and gorse fires already, and this is only May. A quick walk virtually anywhere in eastern England would tell you the woods are totally dry, ready to go up with a whoosh.
Already in Cambridge, our city greens have patchworks of burnt earth where people insist on having barbecues. So you encourage people to go out and start cooking fires. The irresponsibility leaves me open-mouthed.
Work it out
John Walsh makes a valid point regarding the description of Britain as the mainland in relation to Ireland (19 May), and how some exiled Celts may find this offensive. Having pointed out one elephant trap he dived headfirst into the next, telling us that some (presumably unionist) people in Northern Ireland regard England as "the mainland". Two weeks ago, the Scots elected an SNP government, much to the confusion of London-based media. Can you spot the connection?
Donald John Mac Innes
Blame the Scots
Wasn't RBS under Sir Fred Goodwin's stewardship a major contributor to the financial crisis, and HBOS seems to have figured in the mess somewhere? Hardly London banks. Perhaps the answer is to wean Scotland off public funding.
Truth will out
Lord Judge has spoken (report, 21 May) about "injunctions to prevent the peddling of lies". Lies are not the problem. Recent injunctions have been designed to prevent the peddling of truths.
Perspectives on Israel's policies
Cash could be the key to peace
So, Mr Netanyahu has said no. It isn't going to happen. Israel will not give up one inch of the West Bank and somebody had better tell it to the Palestinians, quoth the Prime Minister of Israel. Well, it is clear what Obama's next step should be.
In fact, did he not already hint at it in his speech on Thursday? "Israel," said the American President "must be able to defend itself ..." and then a pregnant pause, followed by the emphasis on the next words, " ... by itself". There you have it, Mr Netanyahu: no more military aid from the US of A. Would that change your mind?
There is one very simple way for Israel to agree President Obama's plan that Israel's borders should be set at the 1967 boundaries and that is to withdraw the cash which bankrolls the Israeli state. In the long term, returning to the 1967 borders would not only increase Israel's security but that of the whole Middle East.
After Obama's speech, I predict that Israel will ignore the US and continue with their land-stealing and ethnic cleansing. With blinkers on, Israel behaves as though nothing has changed and can continue on with their racist policies unchecked. Israel needs to change radically or be forced to confront the realities in a new Middle East.
Yamba, New South Wales
Settlements are officially illegal
I'm sure that David Lewis and others (letters, 21 May) are aware that the UK Government considers Israeli settlements in the West Bank to be illegal. It follows that there is a strong argument against the Ahava shop in Covent Garden selling goods produced in such a settlement.
The UN position on Israeli settlements is clearly stated; UN Council resolution 465 (1 March 1980) refers to "Israel's policy and practices of settling parts of its population and new immigrants in [the occupied] territories" as a "flagrant violation" of the Fourth Geneva Convention".
Their letter proudly proclaims that in Israel, "Arabs, Christians and Druze vote in all the elections, participate fully in civil society, and hold high positions in government and the judiciary", so there is no apartheid.
This ignores the bias of Israel's legal system against its Palestinian citizens and the fact that their "participation" is discounted when Israel claims to be a Jewish state.
The Palestine Mandate of 1922, read together with Article 80 of the UN Charter, confers on Jews the right of settlement in areas of that Mandate that subsequently fell under Jordanian control.
These areas of course include East Jerusalem and the West Bank. The government of Israel is therefore fully entitled – indeed obliged – to permit and facilitate Jewish settlement there.
Those who oppose this settlement need to reflect on whether they are not indeed, at least in some sense, "carrying on Hitler's work".
Professor Geoffrey Alderman
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