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Wednesday 16 February 2011
Letters: NHS and the elderly
I am a nurse with over 20 years' experience and I am dismayed, but not shocked, at the cases highlighted by the health ombudsman ("NHS treatment of the elderly condemned", 15 February).
When I was newly qualified, such cases were not common. Competent qualified nurses took pride in caring for their patients with kindness. Now there is an over reliance on health care assistants. I have met many who are kind and behave in a manner that preserves the dignity of the patients. Others, however, are the people who address patients using language such as "love", "tinkerbell" and "darling". Some are clearly bored with their job, and show an uncaring attitude.
As for the qualified nurses, we have seen an influx of nurses who are trained abroad and whose English is poor. We have also had an influx of qualified nurses who have been poorly trained. Supervising nurses on the ward are reluctant to fail poorly performing student nurses for fear of repercussions – it is easier to pass a student nurse than to fail them and address their shortcomings.
Hospital managers are not interested in supporting ward sisters to ensure that patients are looked after properly, as they are too busy ticking boxes and making sure that pointless government targets are met.
It is not clear that more money and reorganisation will stop the appalling treatment of the elderly by the NHS. There are many profound psychological issues to consider.
Dependency excites complicated feelings. The carer may have fears that their future will involve the kind of extreme dependence they are working with. This can make them rougher than they need to be, as if the patient is somehow to blame for her or his state. In addition there is a shadowy human tendency to react in a negative and occasionally sadistic way to vulnerability. This lies behind child abuse, for example. Much the same can happen with very fragile long-term patients.
If a carer feels undervalued, they may take it out on the patient. But if carers as a group feel like this, then a culture develops in which all kinds of malpractice pass unremarked because the behaviour feels so normal from the group's point of view.
It is important not to locate these kinds of problems in "evil" staff members. They are usually systemic problems and need to be addressed by the organisation as a whole. Staff support that focuses on these hidden psychological factors is crucial.
Carmen Joanne Ablack
Professor Andrew Samuels
Chair, United Kingdom Council for Psychotherapy, London N19
Students who are wasting time
On the strength of nearly 20 years' teaching in the social sciences faculty during the early years of one of the 1960s new "plate-glass" universities, I should like to endorse Amol Rajan's article (14 February) almost word for word.
A candidate for admission to a university should meet two conditions – be intellectually qualified (a B and two Cs at A-level are inadequate) and have more than a superficial interest in his chosen subjects of study. In my experience those conditions were not met more often than not by my mostly reasonably conscientious pupils.
I took my pupils as likely to be well suited to train for a profession or to enter the business world, as no doubt most of them subsequently did. But their three enjoyable years at university were largely no more than a deferment of adult life and a waste of the resources of their parents and of the state.
A financial contribution by the undergraduate is appropriate to recognise the value of a degree personally to him or her, in terms of culture and understanding rather than (often likely to be disappointed) financial expectation; but greatly reduced university numbers would make economical fees much lower than those now in expectation, and maintenance grants at a level enjoyed in years gone by.
And the possession of a British university degree would again become of more significance than it is now.
K P Poole
Amol Rajan dismisses the university as "a holding station for immature adults who want to delay their entry into the world of adult responsibility". At a sweep he dismisses the 40 per cent of them who are part-timers, and already employed in paid or voluntary work.
I'd like him to come and say this to my part-time mature distance-learning students, who give up six years to gain an honours degree, while holding down jobs and care of dependants.
And then there's the usual tripe about "soft degrees" like "golf course management " and "pig enterprise management". Golf is a multi-billion euro enterprise now worth more than €50bn a year in Europe, the Middle East and Africa, according to a study from KPMG (2008). So it would seem intelligent to have a trained workforce. Escape the hackneyed stereotypes and start talking fact about universities and their future.
Principal Lecturer in Community Development and Local Governance, University of Gloucestershire,
It's ridiculous for Amol Rajan to suggest that students sit around smoking spliffs, getting STDs and listening to acid house music. No one's listened to acid house for years.
For at least three decades, Oxbridge colleges have been trying hard to widen their intakes (Steve Richards, 10 February). The entrance examination for which candidates from independent schools were carefully coached was abolished, so that all candidates came to be judged in large part on their achievements in A-level or similar examinations.
Colleges have also very actively encouraged applications from state-school pupils, holding open days and developing partnerships with specific sets of state schools. Such measures have increased the proportion of undergraduates from state schools at Oxbridge from roughly one third to roughly one half.
It is proving difficult to go beyond that figure. The Government is proposing to penalise those universities that do not reach as yet unidentified targets for admitting students from disadvantaged backgrounds. But the problem lies fundamentally with the schools rather than with the universities. Oxbridge colleges cannot admit candidates who do not apply to them. At present, state schools filter out too many of their potential Oxbridge candidates. So a more radical approach is needed than the Government proposes.
How about this? All state schools with sixth forms should be expected to enter a given proportion of their university applicants for admission to Oxbridge (or at least to the Russell Group of universities). Conversely, public schools with sixth forms should not be allowed to enter more than a given proportion of their university applicants for admission to Oxbridge (or the Russell Group).
At present, the debate about university admissions is focused on tuition fees. But concern for social mobility must go deeper than manipulating the cost of a university education. It must involve schools as well as universities.
Alan R H Baker
I understand students from poor backgrounds may pay only £6,000 per annum in fees while those from better-off, but not necessarily rich, families would pay £9,000 per annum.
It seems how much a graduate pays back would be determined not by his or her income – but by their parents'. Two students doing the same course would be charged different fees also. Hardly "fair".
Puzzling over the Big Society
It is always engaging to watch an expert go to work on a hazy text, teasing out all manner of meaning and nuance, whether that text be the Bible, a lengthy court judgment or Prime Minister Dave's pronouncements on his Big Society.
But have we not been here already? Reading your correspondents' recent attempts at analysis of the Big Society, I could not help thinking of the Third Way (vintage 1997). Would anyone care to assess or explain the difference? Write on one side of the paper at a time.
In proposing the "Big Society" as the antidote to "big government", has David Cameron converted to anarchism, the political philosophy which most wants to get the state out of everything?
In an 1896 text, the Russian revolutionary Peter Kropotkin explains that anarchism "seeks the most complete development of individuality combined with the highest development of voluntary association in all its aspects, in all possible degrees, for all imaginable aims; ever-changing, ever-modified associations which carry in themselves the elements of their durability and constantly assume new forms which answer best to the multiple aspirations of all". Familiar?
The way this country is going, soon the only people in paid "work", will be bankers, career politicians, PR people employed to spin reality away from revolution on the streets, and the bean-counters who have slowly but surely ground the "great" out of Britain and who drive the whole fiasco along. Everyone else will be "volunteering" in the Big Society, and living on hand-outs and barter.
Cameron needs the prison vote
Like Richard Ingrams, (12 February) I am a bit baffled as to why David Cameron has such misgivings about allowing prisoners to vote. Any former prisoners I have ever met, as well as having severe dyslexia, tended to be staunch royalists and have strong Tory sympathies, on immigration matters especially.
With all the opposition to his imminent austerity cutbacks, Mr Cameron is going to need all the support and friends he can muster, and overlooking a natural Tory constituency like this is hardly wise. He would be well advised to review his stance on this matter.
Thomas F Maher
Director, British Home Tutors
It has been argued that "those who break the law should not be allowed to make the law". I was astonished that this was said by MPs. Voters are choosing a representative, not making law. Even a referendum does not have to be binding on the legislature.
It may affront a lot of people but giving all prisoners the vote seems a small price to pay for giving them a useful and hopefully educative reminder of their role as a citizen, rather than a disenfranchised outlaw.
John Williams wonders how other European countries have "reacted" to the European Court of Human Rights' ruling on prisoners' right to vote (Letter, 14 February). The answer is that many of them need not react at all. The Czech Republic, Denmark, France, Germany, the Netherlands, Norway, Poland, Romania, Serbia and Sweden all allow prisoners to vote already. In Germany, indeed, the law requires prison authorities to encourage it.
Thank you for your astonishing article on the proposed massive extension to Lydd airport (15 February). I thought for a moment it was a hoax. But reality intruded – they really are actually proposing to ruin a protected and unique environment. And at the behest of a Saudi Arabian billionaire who apparently owns the airport. If we protest will we be beheaded?
John Carew is indeed the victim of a misplaced accent ("When tattoos go wrong", 12 February). The é should be an è in the word règles. The misplaced accent is not the cause of the embarrassing mistake, however, as "règles" – with a grave accent – means both "rules" and "menstrual period". The error was not realising the double meaning of the word, to which is added a spelling mistake.
Your Timeline feature (14 February) does John Cobb a disservice in describing his car as "jet-propelled". The Railton Mobil Special was powered by two Napier Lion aero piston engines. That these drove the car's wheels means that for many of us Cobb's near-400mph speed in 1947 still stands as the record for a real car, rather than a wingless jet plane.
Perspectives on on Arab revolution
Syria won't be so easy
You emphasise the need for Western leaders to stand with the pro-democracy movement in Egypt (leading article, 11 February). However, you then claim that "the repressive rulers of Syria, Jordan, Algeria and Libya will know that if the Egyptian regime can be overturned, with all its military and financial aid from the United States, it can happen anywhere".
Unfortunately, the chance for regime change by a popular uprising in Syria in particular will still be next to nothing for quite some time. It is instructive to ask why the planned "Day of Rage" demonstrations against Bashar al-Assad failed to materialise on 5 February.
The Syrian regime is different because it survives by manipulating tensions between ethnic and religious groups in the country. The ruling family, as well as the political and military elite, all come from the minority Alawite sect, at the expense of the disenfranchised Sunni majority. Hence, as long as the Alawites (along with the Christians and other minorities) see Assad as their protector, neutrality in a confrontation between the regime and the people would not be an option. We would likely witness a culmination of events along the lines of the infamous Hama massacre in 1982 that left some 20,000 Syrians dead.
Popular uprisings that stand a chance of success against authoritarian regimes in the Arab world are the result of years of work by opposition activists at the grassroots level. This is precisely what we are witnessing in Egypt and Tunisia, but no such conditions exist in Syria.
Aymenn Jawad al-Tamimi
Mubarak goes, but the regime goes on
The announcement on Egyptian state television by vice-president Omar Suleiman that Hosni Mubarak had chosen to step down, and that authority now resided with the Supreme Council of the Armed Forces, should serve as a warning to revolutionaries everywhere.
From the start of the troubles the regime made clear that their main priority was the removal of protesters from Tahrir Square. It moved from gentle persuasion to lightly disguised threats, while presenting a series of concessions.
The failure of this policy left the regime, still seeking the dispersal of the protesters, to offer the demanded concession. The apparent retirement of the President was greeted with elation by the crowds while the regime, in the guise of the Supreme Council, stayed in power. It is not inconceivable that this is a ploy that Mubarak hopes will result in his eventual return. However, perhaps he has found out that although he may be dispensable to the United States, the regime is not.
The collapse of the Egypt-Israel peace treaty of 1979 and possible rise of undesirable governments in the Middle East, brought on by the wrong sort of regime change, is unthinkable to the United States. To this end they are compelled to preserve the old order.
The Orderly Transition can thus mean the US being given the time needed for political manipulation of Egypt and ultimately the elections.
Al-Sharif Abdullah bin Al-Hussein
I am sure Tony Blair will agree that the world is a better place without Hosni Mubarak. But does he also agree that the method of getting rid of him was far preferable to the way he and Bush got rid of Saddam Hussein, and, with a little more time, the Iraqi people would probably have done the same thing as the Egyptians?
Stourbridge, West Midlands
Could we make a goodwill gesture to the people of Egypt by returning the Rosetta Stone? This would be the right moment to give them a morale boost, demonstrate the solidarity of democratic nations and get our relationship off to a flying start.
Chew Stoke, Somerset
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