Over the past week, the Government has dealt a double blow to attempts to relieve the current burden on the NHS and improve the health of the nation.
Doctors have been united in their desire to see a minimum unit price for alcohol and the introduction of plain packaging for cigarettes – both of which have been proved to be effective measures. Smoking is the largest cause of preventable illness in the UK, and rates of smoking are twice as high among people with mental illness. Excessive consumption of alcohol is also associated with higher levels of depression, schizophrenia and personality disorders.
At a time of increased pressure on the NHS, those intoxicated through alcohol – and the victims of alcohol-related violence – constitute a major part of the workload of not only A&E services, but also of acute wards, orthopaedic wards, intensive care, and liver and psychiatric units.
We hear repeatedly that the Government wants to reduce avoidable early deaths. But for the NHS to do this, we need the right tools to do the job. We urge the Government not to sit back and wait, but to implement minimum unit pricing and plain packaging as a matter of urgency.
Professor Sue Bailey, President of the Royal College of Psychiatrists, London SW1
Are we seriously expected to believe the Health Minister when he says that the reason for not proceeding with promised plain-packaging plans for cigarettes is the prospect of legal challenge? When tens of millions of pounds are regularly spent on legal action for much less important issues?
The pampered tobacco industry should be grateful it is still allowed to peddle its toxic product in any packaging.
Andrew McLauchlin, Stratford upon Avon
NHS hospital standards neglected
In support of Jeremy Laurance’s analysis (“Mediocrity isn’t the problem – it’s the failure to address it”, 17 July), I can relate with considerable sadness my own realisation that the NHS that I had served for 30 years had developed an ethos to which I could not subscribe.
It was when a medically qualified manager directed that, in the context of patient safety in his department, there was henceforth to be no reference to “standards of practice”, but only to “styles of practice”. Need I say more?
Dr Jonathan Punt, Consultant paediatric neurosurgeon (retired), Wysall, Nottinghamshire
Healthcare, properly delivered, is not and never can be a consumer product. This is the central fact from which the UK has been beguiled by rampant market idolatry. Keogh does not touch on these basics. (“Trapped in mediocrity”, 17 July.)
Professional public service is an honourable vocation that has been denigrated and debauched by successive governments. The deficiencies of the NHS were “plumbed in” from the start. With the benefit of hindsight we can do much, much better.
The first requirement is to define the purpose and limits of the service. Alleviating the fear of illness, injury, suffering and death is a purpose unlikely to change for generations. This is not the same as providing all services, for all people, all of the time and everywhere.
The NHS should provide immediate formal assessment and advice 24/7 everywhere – this is a sine qua non. Vast swathes of minor and symptomatic treatments must be the patient’s personal responsibility. The bulk of non-urgent cold surgery and many other treatments, being predictable in volume and costs, can be farmed out to the private sector with either direct payment, payment via insurance or via the benefit system.
Significant illness and injury must be quarantined from the fatal contamination of market forces – in an area as complex as modern medicine there are no properly informed consumers able to judge reliably between treatment options (and only a few more professionals!). Public-health measures likewise.
All providers must employ a single universal electronic record, contribute to training, undertake directed audit and publish results openly, and adhere to uniform set standards.
Steve Ford, Ex-GP, Haydon Bridge, Northumberland
I attended an outpatients clinic at Kettering general hospital on Monday. The staff advised patients that the waiting room was quite hot and if they wanted to, they could wait in the slightly cooler corridor.
During my wait, I found that central heating was running full blast, radiators too hot to touch! You report that hospitals have been put on alert because of the current heatwave; I don’t suppose the instruction “turn off the central heating” was included in the actions to be taken.
I did draw someone’s attention to the blazing hot radiator, only to be told that quite a lot of the radiators were also pumping out heat and nobody seemed to know what to do about it. That a huge building can be so poorly managed is truly shocking. What else is being neglected?
Dan Kantorowich, Kettering, Northamptonshire
Targets of the snoopers
Stevie Gowan (letter, 6 July) expresses the view that possible government surveillance of his “innocuous and legal personal messages” is to be preferred to the possibility of terrorist plots going undetected because of insufficient vigilance by the security agencies. While I am no keener than anyone else to be blown up by terrorists, I would suggest that his relaxed attitude to government surveillance is misplaced.
The view that only those who are up to no good have anything to worry about from state snooping is wrong, and there are actually a variety of ways in which perfectly innocent people may be harmed by it.
Political opponents of the government of the day, activists and journalists are all potential victims of such snooping. The recent allegations concerning attempts by the Metropolitan Police to smear the Lawrence family illustrate all too clearly that it is not paranoid to consider the possibility that the efforts of the security forces will not always be unambiguously focused on protecting law-abiding citizens.
Of course we should take precautions in the face of the risk posed by terrorism but, just as they are in the face of other, greater, risks such as being killed in a car accident, we should ensure that these precautions are proportionate and appropriate.
Jonathan Wallace, Newcastle upon Tyne
I must most heartily commend and congratulate David Anderson QC, the independent reviewer of terrorism laws, on his words: “Terrorism... provides the ideal reason – or excuse – for the introduction of repressive laws. It makes the careers of politicians, police officers, civil servants, academics, analysts, lawyers and demagogues.”
It is thanks to the beliefs of men and women like Mr Anderson that we have the free society that certain of the aforementioned spuriously claim to be defending.
Nicky Samengo-Turnet, Hundon, Suffolk
Micropoetry on Twitter
Your article about Twitter poetry (17 July) focused largely on established poets who write primarily for print and for whom tweeting micropoetry is a secondary activity, and told only half the story.
In February, I published an anthology called time lines. The book was a collection of writings by poets for whom Twitter is their main outlet, none of whom have publishing deals.
George Szirtes reviewed the book on his blog, which led to interesting conversations on Twitter between him, me and other Twitter poets about Twitterature, its characteristics, limitations and possibilities. An author might tweet material and then receive replies from followers: augmentations, questions, suggestions, variations.
The most exciting thing about Twitterature is that it has offered poetry a lifeline. I know people who would never have sought poetry as their reading material, but who have discovered micropoetry on Twitter and read it avidly.
James Knight , Wells, Somerset
Dinosaurs of the golf course
Close on the heels of your report of 17 July that the remains of a new species of dinosaur (Nasutoceratops Titusi) had been discovered in Utah, subsequent articles on 18 July suggest its descendants may continue to thrive in the east of Scotland.
R&A chief executive Peter Dawson’s feeble attempts to defend discrimination against women at Muirfield on the basis that it is a private club were risible. A major national sporting event such as the Open should embrace the values of the nation.
The honour of hosting any international competition, with all the resulting sponsorship benefits, should entail basic levels of acceptable behaviour. The closing of gaps in anti-discriminatory legislation is overdue.
Graham Bog, Forest Row, East Sussex
Racism was not the only factor in the death of Trayvon Martin. An obsession with crime and “security” also played a part. The killer lived in a gated community, the kind of place where paranoiacs feed off each other’s fears. He was co-ordinator of the neighbourhood watch. Such schemes pander to the prurient and encourage vigilantism.
Keith Sharp, Torquay
The role of an MP is to try and improve the lot of those they govern. Rather than self-interested parties deciding pay rates, maybe their income should rise and fall with changes in average salaries or GDP. We might then get policies designed for all our benefit, not just the few.
Andrew Whyte, Shrewsbury
Do we really need advice on how to survive a heatwave (News, 18 July)? Isn’t it obvious that we should stay out of the sun and drink plenty of fluids? Even a dog knows this. How did our ancestors cope before all this amazing advice was invented?
Stan Labovitch, Windsor
Now, hear this
Having regularly attended performances by the Royal Shakespeare Company over the past 15-20 years, the latest only last month, I feel Dr Doherty’s criticisms are unfounded (Letters, 17 July). Perhaps he needs to see his doctor for a hearing test.
Richard MacAndrew, Arkengarthdale, North Yorkshire