Letters: Patients at risk in our hospitals

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Your article "Hospital staff shortages 'cause 500 deaths a year'" (8 September) shows that too few junior doctors are caring for too many patients overnight and at the weekend. Patients who are admitted to hospital in the evening and at the weekend risk receiving sub-standard care.

Despite the best efforts of consultants who work above their contracted hours, patients are not getting sufficient input to their care from senior doctors during these periods. The supervision and training of junior doctors is also adversely affected by a lack of senior input during these periods. More doctors are required to provide this high level service.

The Royal College of Physicians believes that there is an urgent need to review workforce patterns in hospitals to ensure that medical in-patients receive direct input from consultant physicians on every day of the week. We previously issued guidance for physicians caring for very sick patients. Hospitals admitting acutely ill medical patients should have a consultant physician on-site for at least 12 hours per day, seven days per week, at times related to peak admissions. Consultants should have no other duties during this period.

We can begin now by reconfiguring acute services. Concentrating specialist services in centres of excellence will improve standards and help to provide a consultant delivered service.

Furthermore, junior doctors' contract, the New Deal, and the European Working Time Directive must be renegotiated to provide more local flexibility when designing staff rotas in hospitals.

The RCP calls on the Government to take urgent action to ensure that extended consultant-delivered services, providing safer care for patients and the opportunity for excellent training of the next generation of doctors can be achieved.

Sir Richard Thompson

President, Royal College of Physicians, London NW1

Keep cameras out of courts



Why the rush to film court proceedings? It's not as though it's been a hot topic in the pub, bus or boardroom.

Ken Clarke says it's about transparency. But one thing criminal-court proceedings already are is transparent. Members of the public can go along, watch and listen, and the proceedings are recorded for transcript purposes.

I've seen no mention of how much this will cost us, the taxpayer. I have no doubt that hard-pressed crown court staff are not impressed with money being spent on this when their numbers have been cut beyond the minimum and they are at breaking point.

Paul Nuttall MEP

(UKIP, north-west england)



While there are certainly arguments for a televised judicial system (report, 7 September), it is important to consider the effect of the cameras on judges.

The chance to appear on television certainly provides one with an opportunity to exercise one's ego, as well as raising interest on social media.

It would be naive and ultimately unjust to assume that, while appearing on television with the potential for future celebrity, every judge will remain undaunted, principled and, most fundamentally, impartial.

Charles Lake

Ruislip, Middlesex



Your leading article on the proposed televising of court proceedings (7 September) mentions in passing "the occasionally mooted discontinuation of wigs and gowns on the grounds that they overawe ordinary people".

Overawe? On the contrary. On seeing a judge in full panoply, or a barrister in wig and gown, the natural reaction of any normal, healthy person is to fall about laughing. It would certainly make sense to get rid of these ludicrous comic-opera costumes if "ordinary people" are to take the legal system seriously.

John Smurthwaite

Leeds



Target traders in stolen metals



The continued theft of metals such as lead and copper is now of a magnitude to merit a co-ordinated response on a national scale. Each time the price of these metals rises, there is an increase in this criminal activity. This is proving a particular burden on churches, few of which have escaped losing lead from their roofs. The cost of replacing the stolen lead has to be borne by the individual church and its congregation, often a very small number of people, who have to pay for the replacement. And some churches have had their lead stolen again and again. In this latest spate of thefts, over 40 churches have been affected in the Diocese of Lincoln alone.

Of course measures are taken to deter such thefts, including for example installing intruder alarms. The police are involved but with only limited success in apprehending the thieves.

But while thieves can readily dispose of the stolen metal, they will continue to gather this free harvest – whether lead from church roofs or copper from railway lines. The stolen materials are worthless unless they can be sold to somebody prepared to accept them, and this appears not to present any great difficulty to the criminal.

Given the quantities of metals being stolen, there must be in operation fencing on an industrial scale. This is surely where the police and other law-enforcing bodies need to target their efforts; and this must be cross-constabulary and preferably co-ordinated nationally. If the harsh light of investigation is focused on the scrap-metal dealers and subsequent recyclers/smelters, then we might begin to tackle this criminal activity.

Stan Underwood

Lincoln



Don't let bankers ruin us all



Part of my job during many years in banking was reading fiction or semi-fiction, also known as balance sheets. We often had to guess what the real truth was about the information with which we were fed and guard against being deceived.

Then we get "Chinese walls", the purpose of which is to ensure that information important to one part of a business would never be passed to another. Pull my other leg, the one with bells on it.

Now we have the latest fashion, "ring-fenced assets", which no one has yet explained in detail. It seems that by magic if one part of a business goes bust, the other by magic does not. How does this work legally?

No, the gambling side of banks must be completely divorced from the old-fashioned side so that if the gamblers go broke, as they will, the traditional side will not. No "ring-fencing": two different businesses, legally separate, with separate names.

This is not a technicality; the future of our country is at stake.

Peter Croggon

Fellow of the Chartered Institute of Bankers London SW16

Protect religious freedom in Syria



With the authoritarian regime of Libya's Gaddafi effectively replaced, attention is bound to move to Syria, and hopes are high in some Western capitals of being able to engineer a similar transition.

However, Syria differs from Libya in one crucial aspect; its religious diversity. Christianity took root in Syria at its very beginning and the country has churches and monasteries that trace their roots all the way back to that time.

While historically there have been incidents of serious religious violence, in recent times Syria has had relatively harmonious relations between Muslims and the indigenous Christian churches, both Orthodox and Eastern Rite Catholics. It has provided a haven for refugees from Turkey and more recently Iraq, a disproportionate number of whom were indigenous Christians fleeing from targeted attack.

Whatever the mistakes, or worse, of the al-Assad dynasty, it has deliberately promoted religious tolerance, a unique achievement of inestimable value and a lesson to the rest of the Middle East. Some senior Islamic clerics in Syria have remarkably good relations with leaders of the indigenous churches and see them as an integral part of the country, and an important ally against Islamist extremism.

Western politicians should be taking note, and journalists should be talking this up. While overt support for Christians in Syria by the West will condemn them in the eyes of radical Islamists as "Crusader" stooges, any support for the Syrian opposition must demand that, if they come to power, they continue that same policy of full religious toleration.

The religiously inspired barbarity that followed our attempt at recent "regime change" in Iraq must not be allowed a second appearance.

Nicholas Crampton.

(Co-ordinator, Eastern Christian Links)

Mundford, Norfolk



National Trust is out of touch



The opposition of the National Trust to more housing in rural Britain shows how out of touch this "charity" is. In Cornwall its isolation from the local community is stark. We face the worst affordability problem with housing in the UK. The problem is worsened by the selfish use of large amounts of Cornish housing for second homes. The Trust is itself a large owner of second homes in our region. To protect the countryside it should join the Cornish campaign to curtail second homes and so reduce the need for green-field developments. But I guess National Trust members either own or aspire to own a second home and are not going to want to see this as the problem.

The result is an ethnically cleansed and sanitised countryside devoid of young Cornish people or an income spread in the villages. A countryside, in fact, just like a National Trust stately home - nice to look at, but devoid of life. In Cornwall the Trust adds insult to injury as it refuses to use the Cornish language at any Cornish site.

It's time the National Trust was made accountable to the communities it is hosted by. It is difficult to see why the nimbys at the Trust get tax breaks while Cornish rural schools close.

Tim James

Penzance



The sham of school targets



Your leading article "A fraud on all our pupils" (7 September) claims that schools have cheated, "to ensure the school met its targets and occupied a higher position in the league tables than it would otherwise have done".

Since there can be few heads who have not grasped that recent governments have reduced education to a game that they must win, then it might be fairer to claim that they have acted to ensure that their schools do not fall below their rightful positions in the league tables.

Just where should the lines be drawn between the wholly acceptable, the dubious and out-and-out fraud? Entering pupils for "equivalent" qualifications in order to enable potential GCSE failures (below C grade) to pass is, presumably, acceptable even though it may mean that able pupils are not stretched and may be prepared inadequately for A-level.

How do we judge a head who instructs a teacher to check coursework and demand recommended improvements until the target grade is reached? Teachers are, after all, required to state that the piece is entirely the work of the pupil.

When marking history coursework I used to set the mark for the best piece according to what, I judged, would be the highest I could get without having the moderator reduce it. Were I to award, say, 86 per cent when another school might award 94 per cent for work of a similar quality, I might have deprived my strongest students of their A* and A grades. Even worse, I might have plunged several pupils from a potential C to the dreaded D. Was this acceptable?

Schools that have played the game and seen their A-C grades soar have had praise heaped upon them. They have been congratulated for the "improvements" that they have made. Schools that have not played according to the new rules and seen their pass rates stagnate have been judged to be "failing".

The teaching profession is not responsible for the political game and its rules. It has simply responded to the demands of government. If the present government is unhappy with the outcome, it should take responsibility for changing the game.

Stephen Shaw

Nottingham



Riotous times in Brighton



During the last few days I have been reading the excellent book Family Britain by David Kynaston about life in the 1950s. Given the outcry over the recent riots and what they tell us about the breakdown of families etc, I was amused to come upon the following few lines: "In late April [1952] the Brighton and Hove Herald reported a wave of wanton destruction by teenage hooligans striking the seafront, with juvenile gangsters vandalising property and assaulting passers-by; soon afterwards, Disgusted of South Wales complained to the local paper about vandalism in Aberfan's cinema and attributed it to lack of parental control." So don't panic – we've been here before and apparently survived.

Professor Brian Everitt

London SE19



Greed motivates this quest for oil



In your piece about oil exploration in the Arctic and the potential for natural disaster ("Oil exploration under Arctic ice could cause 'uncontrollable' natural disaster", 6 September), it should be noted that the best estimation of 160bn barrels of oil is still only five years' of total global consumption.

So we would be putting off the inevitable end to this finite resource at great risk to the environment and at great cost. It seems that the motivation is greed rather than investment in sustainable and renewable long-term solutions.

Jake Backus

Oxford



A fine romance



When I read Wuthering Heights as a teenager it certainly tweaked my romantic nerve. Kaleem Aftab (Viewspaper, 7 September) is fascinated that director Andrea Arnold has deprived the new Wuthering Heights film of any romance.

On re-reading the book at 50 I didn't recognise the characters I thought I had found there previously; it is book full of cold, hard people with few redeeming qualities, bent on self-destruction or the destruction of others, with no romance, just the desire to own or dominate.

Clare Shepherd

Blandford, Dorset



Why Trident?



The short answer to Robert Hinde's question (letters, 7 September) about retaining Trident is "continuing delusions of grandeur". Or (to replay the opinion of Dean Acheson, US Secretary of State at the time of the 1956 Suez crisis): "Britain has lost an empire, but has yet to find a role".

Michael McGwire,

Swanage, Dorset

Perspectives on tax havens

Nothing immoral about Jersey



Paul Vallely's recent article "There is no moral case for tax havens" (29 August) lumps all international financial centres together under the pejorative term "tax haven" and thereby fails to take into account the diversity and quality of the jurisdictions he derides.

Just as democracies vary in strength and quality, offshore financial centres occupy a vast spectrum from the opaque, secretive jurisdictions to the cooperative, transparent and well-regulated centres. Jersey is clearly at the latter end of this spectrum. Indeed, Jersey has been independently assessed as compliant or largely compliant with 44 of the Financial Action Task Force recommendations to combat money laundering and terrorist financing. To put this in perspective, the UK has only been deemed to be compliant with 36 of these. With this in mind, Vallely's position that all international financial centres are sanctuaries for the spoils of "theft, fraud, bribery, terrorism..." is clearly untenable.

Vallely goes on to posit that there is a direct and detrimental relationship between offshore financial centres and the developing world. This argument is unsupported by the evidence as amply demonstrated in independent research conducted by Professor Sharman of the University of Griffith.

Finally, the terms "tax avoidance" and "tax evasion" really should not be conflated. It is the right of every taxpayer to arrange his or her own finances in the most effective and efficient way. Tax evasion, by contrast, is rightly illegal. Far from proving his case that "tax havens" are in some way immoral, the onus is on Vallely and others to make the moral case that individuals should not have the right to choose how they manage their affairs.

Geoff Cook

Chief Executive,Jersey Finance Ltd

Jersey, Channel Islands



Loopholes in the British Virgin Islands



Sherri Ortiz overlooks the crucial role that the British Virgin Islands plays in assisting wealthy investors to avoid paying their taxes (Letters, 1 September). The Tax Information Exchange Agreement with the UK leaves this particular loophole largely untouched.

Much of the foreign money held in Swiss bank accounts is not booked in the name of the actual, or beneficial, owners of the funds. Rather it is held in the name of companies registered in corporate secrecy jurisdictions, such as the British Virgin Islands.

Since company registers in these jurisdictions are not open to public examination, it is very difficult for the tax authorities to be aware of the existence of these companies – let alone whose money is concealed in them.

Nigel Wilkins

London SW7

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