Letters: NHS funding


Amid an IT fiasco and a storm of 'targets', MPs blame the doctors

Sir: It is disgraceful that MPs on the Public Accounts Committee should seek to put the blame for the current NHS funding crisis on the the shoulders of doctors.

What about the millions of pounds the Government is forcing the NHS to pay to private companies to do operations that could be done better and more cheaply in-house? What about the money being poured into the multi-million pound fiasco that is the "Connecting for Health" IT project that very few health professionals actually want? What about the ever-increasing number of "management consultants" being brought in to service the ever-expanding numbers of "targets" and "initiatives' pouring out from the Government?

Doctors determine treatment based solely on what is best for the patient. These decisions are based on clinical need and based on the years of training and experience of doctors. To try and tell them that the decision should be based instead on cost can only be detrimental to patients.



Sir: The Public Accounts Committee deem doctors to be responsible for overspending in the NHS. The truth is entirely the opposite - it is because the medical profession do not have enough influence in spending decisions that health service finances are in such a mess. The Government has spent £12bn on overblown, unworkable NHS IT projects that will have no real benefits for patients, enough to pay for the entire NHS deficit twelve times over. Blaming doctors for government mistakes will do little for morale - and demotivated doctors will not make for better patient care.

We are among the most dedicated and hard-working of public servants. Unlike MPs we cannot vote for our own pay rises, otherwise I doubt that GPs would have received a 0 per cent pay increase this year.



Olympic legacy for London's poor

Sir: London is the only British city which could have won the Games ("The cost of victory" 16 March). London business backed the 2012 bid mainly because of the social and economic benefits the Olympics can bring.

While many British cities experience high levels of deprivation, few, if any regions have such a high concentration in one area, with 52 per cent of children in inner London officially classified as living in poverty - almost twice the national average. The neighbouring Olympic boroughs of Hackney, Tower Hamlets and Newham rank among the most deprived local authorities in the country, indeed in Western Europe.

Now the Olympic budget is settled, government must ensure that in the race to deliver the event, the long-term legacy is not forgotten. That means starting now to build schools, health centres, bridges, roads and rail links, not just stadia and media centres.

If the Olympics enables more of London and more deserving Londoners to share and contribute to the capital's success, the £9.3bn should prove to be money well spent.



Sir: When London beat Paris to be named host for the 2012 Olympics, I didn't quite know how to face my French friends: should I crow or commiserate? "Don't worry," one of them said. "I think most of us are relieved; it will save us a lot of money." I see what he meant, now.



Sir: Am I the only person who thinks that just this once we should forget about the cost and make sure we put on a fantastic show that the whole world will love no matter how much it costs? After all, given the impacts in terms of CO2 emissions such global events as the Olympics create it's highly unlikely that many future generations will be lucky enough to enjoy such celebrations of sporting excellence.



Ethical trade in flowers from Kenya

Sir: The War on Want report "Growing Pains" gives the impression that neither the government of Kenya nor British supermarkets have any concern for the health of flower cutters or flower farmers ("The pain and abuse behind a Mother's Day bouquet" 15 March).

War on Want is wrong to assume that health risks associated with pesticides are left unattended by government. The government of Kenya sponsors organisations to educate persons exposed to agrochemicals on the safe use of pesticides. The Agro-chemical Association of Kenya has been at the forefront of this for a very long time.

Since moving to the UK I have been amazed by the persistent attacks which British supermarkets - some of Kenya's best customers - are subjected to. I know that if supermarkets stopped buying our produce, the only losers would be the very same people that organisations such as War on Want believe they are helping - the poor. I am not saying that people should be exposed to danger or disease just to ensure that they have jobs. We have an obligation to our citizens and to our customers to ensure that our trade is ethical.

Eurep GAP and Kenya GAP are codes of practice commonly applied in the Kenyan flower sector. They are both internationally recognised and they are both very clear about the use of pesticides.

War on Want may have had the best intentions when they set out to promote corporate accountability and greater awareness among consumers about the source of their flowers, but in this instance they have distorted the picture grossly, threatening the livelihoods of hundreds of thousands of Kenyans and their dependants.



Unions battle for women workers

Sir: Joan Smith is mistaken in her analysis that unions are letting down women workers (Opinion, 13 March).

Unison has a proud record on equal pay. We fought a lonely battle on this issue when most employers and governments were unwilling to face up to their responsibilities and tackle equal pay

In local government we want a formula that will deliver equal pay to all council employees. Our goal is to develop pay and grading structures that are fair to workers and at the same time protect the vital services that the public rely on. These are tough and difficult negotiations very far from the "sweetheart deals" claimed.

The Government requires councils to make 3 per cent annual efficiency savings and reduce the pay bill. This is at odds with their ability to find funds for equal pay and single status. Local councils are under-funded and limited by government on borrowing. The Government needs to face up to its responsibilities and its stated aims to deliver fair treatment for women and put its money where its mouth is.

No-win-no-fee solicitors are making money out of the complex legal situation surrounding equal pay cases. Civil litigation is long and complicated and we would prefer to strike a balance through negotiations. However, we have always made it clear that where employers will not negotiate acceptable agreements, we will take legal action.

Unison is currently bringing legal claims for equal pay for thousands of women members working in schools, councils and hospitals. Women members who come to Unison for legal help will not have any of their damages deducted to pay no-win-no-fee lawyers' fees.



The challenge of deer stalking

Sir: While I abhor the concept of the computerised hunting of animals in compounds to which Terence Blacker refers (14 March) , deer stalking in the wild as both a skill, a challenge and a management tool is an essential part of what goes on in our managed countryside.

Man has hunted for food since time immemorial. With deer stalking, every animal that is killed is destined for the table. Deer may be shot for sport, but they are also shot for food.

Moreover, deer are culled not just to reduce impacts on their environment but also for deer welfare reasons - to match populations to the capacity of the land that has to sustain them.

Deer management has a cost, and it is perfectly reasonable that that cost is offset by letting stalking. In fact, deer management in total generates in the region of £105m for the Scottish economy per annum, and it sustains jobs in fragile rural areas.

Ultimately stalking is no different from the humane dispatch of any other animal for human consumption - but for the fact that it takes place in the natural environment. I know of no individual who would "glory" in the death of a stag. I know of many who follow best practice to the letter, enjoy what they do, and in so doing not only gain from that experience, but also give back in spades. Whatever Terence Blacker's experience may be, a day with a stalker on the open hill can be without doubt an exceptional and an enlightening experience.



Save the planet from business meetings

Sir: You have published another letter about whether it is better to travel the length of the country by rail or air and - surprise, surprise - air comes out both quicker and cheaper (19 March). But do we need to be travelling the length of the country at all? With instant emails and telephone and video-conferencing are all these journeys really necessary?

A lot of business people need to charge about looking busy in order to justify their jobs; a lot of business people quite like charging about staying at hotels and eating in restaurants - or they are too frightened not to in case they are replaced by someone who will. And I suspect that goes even more for international business meetings too.

The poor lambasted holiday-maker who travels once a year has much less impact on the environment than all those frequent-flyer business passengers.



Sir: The Conservatives propose to tax air passengers to discourage flying and so reduce CO2 emissions. The aim is noble, but it's unlikely to work.

A few pounds on an airline ticket (and I doubt that any government would dare levy more than a few pounds on a short-haul flight) is an inconvenience, but insignificant in the cost of a holiday. Such a tax would annoy fliers but not change habits. The idea that it would be revenue-neutral sounds fine but there's no way to check that the promise has been kept.

A personal carbon allowance would be more useful: it says to everyone that they have a part to play in tackling climate change, and leaves each of us free to choose what we do.



Intervention from the upper house

Sir: There can be no greater advertisement for a fully elected upper house, than the outburst from Lord Turnbull against an elected member of the lower house.



Sir: An elected House of Lords risks damaging democracy. When the real threat to our liberties is an executive ready to use the whips to force controversial policy even on its own party, the last thing we need is more legislators from the narrow world of party politics elected by an increasingly apathetic minority of the population. The Lords tests and improves legislation with a level of expert scrutiny rarely found in the Commons. There is nothing undemocratic about appointments provided they are made by an independent panel on criteria laid down by Parliament.



Rights and duties

Sir: Baggini's analysis of mainstream English communitarianism (Andreas Whittam Smith, 19 March) comes as no surprise to me, but has anyone ever asked those who say "no rights without responsibilities" what the corresponding obligation is to, say, the Convention right of no punishment without law?



Offensive weapons

Sir: It would appear that one of the many reasons given by those who carry knives is the fear factor - they feel they need to carry one for their own protection. Listening to the Prime Minister prattle on yesterday about the people who carry knives I was driven to wonder what sort of message he and the Conservatives led by Cameron sent to the youth of this country last week by their insistence on spending 20 billion pounds on their equivalent of a very big knife when they voted in favour of Trident



Diagnosis of ADHD

Sir: An article by Johann Hari ("Change our schools, not our children", 15 March) claimed that in the BBC 2 documentary, "The Trap" I said that 20 to 30 per cent of the diagnoses of ADHD in children are mistakes. Mr Hari was repeating what other newspapers had reported. I never made such a statement. Mistakes are made in all medical diagnoses but the extent to which this applies to ADHD is not known.



Alternative history

Sir: If only we had decided not to invade, all would have been well in Iraq these past four years. We wouldn't have kept killing 100,000 Iraqis annually with UN sanctions, Saddam wouldn't have realised his WMD ambitions, started any more wars, gassed any more villages or teamed up with international terrorists - and no worse civil war could possibly have resulted had Saddam been toppled internally. In fact, time would just have stood still in this alternative anti-war history ("Drenched in blood", 20 March).



Conflicting signs

Sir: I too find it increasingly difficult to comply with many of the signs that surround us. Only the other day I was about to go into a public toilet when I saw the sign saying, "Please leave this toilet as you would wish to find it." Catching a glance through the door I noticed the floor was in need of a clean and the mirror was smeared. I wasn't keen on the colour scheme either. Being short of time and without cleaning materials I had to pass by.



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