Letters: How the new-look NHS should work

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I cannot agree with Anthony Rodriguez (letter, 31 December) about an end to a free NHS. It is accepted that the present level of activity in the NHS is unaffordable, and that an acceptable standard of health care (still free at the point of delivery) can be provided by working in different ways.

The problem for acute hospital trusts is that, in a lot of cases, this means primary care providers seeking to avoid admissions by improved treatment in a community setting, leading to a reduction in bed usage, and thus income, for the acute trusts. It seems sensible to allow hospitals to fill this potential spare capacity by tapping into a different market (the private sector), to maintain income and viability.

The real trick lies with the commissioners of NHS secondary services (the clinical commissioning groups) being robust and forceful enough to ensure that their local populations do get the best possible health care within the NHS, from their acute hospital providers.

Allowing greater market flexibility for acute hospitals, and having a more collaborative relationship between commissioners and providers, is the only way to ensure a viable and acceptable NHS that will continue to be free at the point of access.

Dr Adrian Canale-Parola

Chair, Rugby Clinical Commissioning Group

Any parent or sibling who has watched a loved one engulfed by the tidal wave of severe mental ill health will have been heartened by Stephen Dorrell MP's warning (31 December) that an unreflective rush to health reform risks drowning those facing "non-sexy" conditions without trace.

Mental health services have long suffered from a lack of political cover and public solidarity but there are signs that patient vulnerability in this sphere is being compounded by the emerging attitudes of health commissioners. When psychosis or rapid change in condition due to extreme sensitivity are constants, managerial focus on "discharge targets", "rapidity of patient churn" and "speedy stabilisation" against clinical advice costs lives.

For Dorrell's nightmare scenario to be avoided, Andrew Lansley will certainly need to take renewed central responsibility for protecting those who even the most dedicated of local carers cannot.

Francis Davis

Southampton

The reports on the increase in depression and the amount of prescribed anti-depressants are indicators of our troubled times.

Insufficient mental health professionals qualified in the likes of CBT, EMDR, counselling etc see overstretched GPs with no alternative but to reach for prescription pads to relieve their patients' mental distress.

Mental health charities struggling to survive are forced to reduce their services due to funding cuts. We have invested much in raising awareness of mental illness: by doing so we have asked people to seek medical help. In not being able supply that emergency help and long-term support our leaders and NHS fall short.

Jean Johnston

The Cairn of Mental Health, Helensburgh, Strathclyde

Parallels with Anne Frank and Stephen Lawrence

In January 1997, I had the privilege, as executive director of the Anne Frank Trust, of introducing Doreen Lawrence to Tony Blair, a few months before the landslide that would sweep in a Labour government. At that time, the racist murder of Stephen Lawrence was a four-year-old unsolved crime case, hardly mentioned in the press and long having moved on from discussions over dinner-tables.

The occasion of the Blair/ Lawrence introduction was the launch of a new Anne Frank travelling exhibition, called A History for Today, at Southwark Cathedral. As owners of the exhibition, we had chosen to include a panel about Stephen, to show that hatred could destroy another talented teenager's life, not in 1940s Holland, but just a few years ago right here on the streets of London.

Featuring Stephen's family photos, his certificates and architectural sketches, all generously loaned by Doreen, and while not comparing the enormity of the Holocaust with an individual murder, the panels showed two teenagers separated by 50 years, one an aspiring writer, and one an aspiring architect, and powerfully demonstrated the senselessness of lives of promise having been cut short.

The morning at Southwark Cathedral was poignant and memorable, and proved to be significant for our country. I was told a few years later that Tony Blair had been so impressed and moved by Doreen's description of Stephen's life and death that he vowed that morning that should he become Prime Minister he would commission a proper inquiry into the handling of Stephen's murder. And Lord Macpherson's inquiry has changed so much in British institutions.

I would like to pay tribute to the Lawrence family, to their resilience and determination. Stephen's adulthood will never be lived, and like Anne Frank, we can only speculate about what his life choices and experiences would have been. But from my experience of working with both his parents, he would have been a terrific and caring young man. How cruel a thing is racial bigotry.

Gillian Walnes MBE

Co-founder and Executive Director, Anne Frank Trust UK, London NW5

I was interested to read that the Metropolitan Police detective Clive Driscoll (report, 3 January) had been attending a service at St-Martin-in-the-Fields with dignitaries including the Prime Minister, Gordon Brown, politicians and the Archbishop of Canterbury to commemorate the 15th anniversary of Stephen Lawrence's murder when news came of a breakthrough which led to the evidence which has subsequently established the culpability of his murderers. At this same London church last year, I attended a Christmas carol service and was shocked to discover that apart from one black choir member, none of the participants, servers or readers, was black. This, in the heart of London which has become one of the greatest multi-racial cities in the world.

As an outside observer of England and the English, it appears to me very much that racism is something of an elephant in the room.

What might have been expected in this case was a prompt solution to an ugly crime from the police and the CPS, simply to uphold the notion that racism, either apparent or implied was unacceptable. Instead, it dragged on for 18 years. No one emerges from this with flying colours.

Michael Rolfe

Sydney, New South Wales

At long last, we have some semblance of justice for Stephen Lawrence. During the 18 years it has taken to reach this point, the shortcomings in both the English judicial system and the police force have been laid bare. Many times, the phrase "institutionally racist" has been used in reference to the Metropolitan Police regarding their handling of this case. But I think they are guilty of something worse, if that is possible, which can and has affected many other cases and inquiries, and that is that the police at all levels acted unprofessionally. This is evident in the opinion of many people who have any experience of dealing with the police. Ask anyone who lives in any of this country's more deprived areas.

Policing is a difficult job but it will become much harder if the police continue to lose the respect and support of the people due to their lack of accountability and often unprofessional conduct which seems to be increasingly evident.

Rachel Hasan

Anslow, Staffordshire

In your analysis of how the Stephen Lawrence case transformed the media, you rightly point out that "the real change in coverage came in February 1997 when the Daily Mail printed pictures of the five suspects on its front page under the headline 'Murderers'."

You weren't quite so accurate, however, to claim that "at first the murder largely made only local news". You report that The Independent was "one of the few news organisations to pick up on the story" but that "Fleet Street took a while to throw off its old instincts".

That's certainly not true of the Daily Mail. For the record, we ran a substantial news story on 24 April 1993 (Stephen was killed at 10.35pm on 22 April) headlined: "Murdered just for being black".

The article, which began "A black student has been stabbed to death by a gang of white youths in what police believe was a racial attack", went on to report that it was the third racial murder in the area in little more than two years.

Alex Bannister, Group Managing Editor, Daily Mail

London W8

The debt we owe to Winston Churchill

Any failings by Winston Churchill in his first 65 years were forgiven because of what he did in the next five (letters, 3 January). Concerns over Gallipoli, the General Strike and so on pale into nothing when compared to the debt we owe him for his leadership in the Second World War.

Richard Welch

Nantglyn, North Wales

If, as Gavin Lewis claims, Churchill's status "was largely a construction of the Churchill industry, which began to get into gear during the shifting demographics of the post-1970s era", it was unlikely to have influenced the decision to grant him a state funeral in 1965.

JES Bradshaw

Southam, Warwickshire

Number's upfor the date

I couldn't disagree more with David A Harvey (letters, 3 January) about how we say the year. Before the millennium, we used the two-part form which states the century first, then the year, "Ten sixty-six", "Eighteen twelve", "Nineteen fourteen", so why should the 21st century be any different? Does Mr Harvey say "One thousand and sixty-six" or refer to the "One thousand nine hundred and fourteen-eighteen War"? In fact, rather than blame the BBC for saying "Twenty twelve", I blame them for not using this form in previous years and encouraging the "Two thousand and..." nonsense.

Garry Humphreys

London N13

The BBC are to be applauded for forsaking the ludicrously long-winded "two thousand and..." formula, and should indeed have done so from the start of the millennium. There is nothing in the least "American" about saying "Twenty twelve". The Americans themselves say "Two thousand twelve, (leaving out the "and"). "Twenty twelve" is in line with conventions for pronouncing the date which go back as far as any native speaker can remember.

Graham Pechey

Girton, Cambridge

When growing up, I observed that when a measurement was given such as 1,728 miles it was spoken as one thousand, seven hundred and twenty-eight miles. But if an event happened in 1728, it was "Seventeen twenty-eight". I concluded that year numbers were treated differently. As I was reading science fiction from an early age and often read about events occurring in this and future centuries, it seemed obvious that the year 2117, say, was "Twenty-one seventeen". I don't think I've heard anyone refer to this year as two thousand and twelve.

Paul Dormer

Guildford, Surrey

When someone asks me in what year I was born, I answer "nineteen-forty-four" but I assume David A Harvey would prefer I say "one thousand, nine hundred and forty-four". I must also confess that, in speech, I also refer to George Orwell's famous book as "Nineteen-eighty-four" and the year of the Battle of Hastings as "Ten-sixty-six". What a hopeless case I am. I suppose my having a great-great-grandmother born in America must have something to do with me having such a very non-British attitude towards dates.

Graham P Davis

Bracknell, Berkshire

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