Letters: Perspectives on NHS funding

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The Independent Online

Our once-envied system is at risk

The impression that the NHS has survived the cuts and its budget "ring-fenced" by the Coalition Government needs to be examined. Although the NHS budget has been relatively protected, the health service has to find cost savings of £20bn by 2014 and this is already resulting in cuts to services and staff and rationing of treatments such as cataract and hip-replacement operations.

The assertion that the NHS spending will grow in real terms is hollow: a commitment to a 0.1 per cent real-terms rise in annual spending is neither here nor there. With inflation in health-care running at more than 4 per cent, the NHS's purchasing power for drugs and equipment will suffer significantly; much money will also be used to pay PFI debts.

Further, the promise of free prescriptions for the long-term ill, one-to-one cancer nursing care and one-week waits for cancer diagnostics, promised by the last administration, are being scrapped. The £2bn announced for social care, too, is an economic deception, since £1bn will actually be drawn from the current NHS budget itself.

The overall effect on healthcare will be a declining share of GDP, which is unlikely to be enough to keep pace with the demand for services, fuelled by the epidemics of obesity and its consequences – diabetes, heart disease and cancer – and the pressure of costs. The White Paper reforms will use much of the money to outsource large numbers of healthcare jobs to the private sector. This will also reduce the public-sector pensions burden. In addition, the policies will generate demand for the healthcare insurance industry, as rationing will increase because of financial pressure.

The universal healthcare provided by the NHS – once the envy of the world – is at serious risk of becoming unsustainable.

Dr Kailash Chand, Stalybridge, Cheshire

New technology will improve efficiency

In "£6bn funding gap threatens NHS services" (26 October), you cite the "traditionally faster rising cost" of medical technologies as a factor causing inflation in the NHS to be higher than the rate of inflation as a whole. I refer you to the figures published by the Office for National Statistics in 2009 that showed that, far from being a cost driver, the cost of goods and services in the NHS, which includes medical devices, rose at barely a third of the rate in the economy as a whole.

Furthermore medical technologies can allow healthcare to be delivered in a more efficient way, ranging from advances in surgical procedures and helping patients leave hospital sooner, to treatments that allow care to be provided in patients' own homes.

The issue for a large publicly funded system is to make the difficult decisions about using technologies in ways that enable staff to use their time more productively. We work to support the NHS to reap the benefits of technology. As with most engineering however, prices fall over time in relation to the value of the product.

Peter Ellingworth, Chief Executive, Association of British Healthcare Industries, London SE1

Bush's flirting with torture

President Bush sought to justify "waterboarding", a form of torture, to a British audience, by claiming that it had helped to prevent terrorist bomb attacks in Britain. We cannot know whether this claim is true.

However, even if it is, Britain's complicity in torture, in allowing "extraordinary rendition" to take place on British soil, in the participation of MI5 in the interrogation of torture subjects and in acting on information obtained by torture, have all contributed directly to radicalising British Muslims.

The radicalisation of a relatively tiny minority has led to incidents like the attempt by a Muslim woman to murder a British MP, and may have contributed to the radicalisation of the 7 July and Madrid bombers. So, even if Bush's claim that information obtained by torture has prevented some terrorist attacks is correct, it has almost certainly increased the overall threat from terrorism that Britain now faces.

By using any form of torture the West obtains dubious intelligence, at the expense of radicalising thousands of Muslims around the world – the foot-soldiers, insurgents and suicide bombers – some of whom might otherwise have been less open to the doctrine of hatred preached by Islamic extremists.

Julius Marstrand, Cheltenham

An unrepentant George Bush has admitted that he vigorously supported the torture procedure known as waterboarding, because "a lawyer" said it was perfectly legal. He made the dubious claim that many lives were saved and he kept America safe by approving the practice.

Predictably, Bush skirted the issue of the legality of waterboarding of Americans who may be captured in war. He and former British Prime Minister Tony Blair offer no contrition for their decision to deliberately mislead their nations about Iraq's weapons of mass destruction. He writes: "No one was more shocked or angry than I was when we didn't find the weapons. I had a sickening feeling every time I thought about it. I still do."

Iraqi civilians and coalition troops who have sustained emotional and physical injuries will find small comfort in Bush's appalling admission that the war was waged on a mountain of lies.

Bush found solace that he "won't be around" when future historians judge his presidency. I wonder if will be so nonchalant when he meets his creator.

Jagjit Singh, Los Altos, California

Has it not occurred to George Bush that the US was the main prosecutor of war crimes at Nuremberg, where the plea of "I was only following orders" was not sufficient defence? In Bush's case, as President of the US, he had no need to follow orders, but a duty to uphold US and international law.

On 10 December 1948, the General Assembly of the UN adopted and proclaimed the Universal Declaration of Human Rights which has been incorporated into US law. Article 5 and 6 of the UDHR states that: "No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment", and Article 6 that: "Everyone has the right to recognition everywhere as a person before the law".

It is now crystal clear from Bush's admission that he authorised the violation of Article 5 of the UDHR and of US law: that – as well as much, much more – is one part of his legacy. That is why he is also wrong to shrug: "It doesn't matter how people perceive me in England."

Oliver Thiebaud, Pitstone, Buckinghamshire

Now that George W Bush has told us that waterboarding is an effective means of obtaining information and is not illegal, does he not owe it to us Doubting Thomases to submit himself to a couple of sessions while being interrogated about whether he genuinely believed that Saddam had WMDs pointed at the West?

Charles Bidwell, Oxford

Chinese don't care what we think

I was mildly amused by the preposterous posturing by the British media and our PM on the news of his visit to China.

Were we going to bring up the subject of human rights? And what would we do if they don't answer? Don't we get it? China is miles ahead of us economically; we are the third world to them. They would laugh at our trains and the state of our roads. Our little voices will be booed away. We need them far, far more than they need us.

Aftab Jeevanjee, Chichester

One of the major criticisms of China's democratic deficit is that only those who are members of the Communist party can stand for office. Could I remind everyone that in the UK Parliament, only those who are members of the monarchist persuasion can take a seat in the Mother of Parliaments, with only those with friends in high places, including God, "representing" us in the Lords. Perhaps we should set an example and fully democratise our own system before we preach to the rest of the world.

Colin Burke, Manchester

Risks of drive for faith schools

Your editorial of 10 November rightly praised the success of Tauheedul Islam girls' school for its outstanding academic success and the fact that it has been asked to help a failing secular school. You have taken this as an "example of how the new system can work". But this news tells us nothing about the actual or potential success or failure overall of such schools, the rights or wrongs of rolling this programme out further and the possible long-term effects on social cohesion in this country.

All it confirms is that well-run schools that select their pupils can do well. It has now been shown conclusively that overt or covert selection, which in the latter case has been shown to encourage dishonesty from some parents, is the chief reason for the relative success of religious schools in this country.

The expansion of religious schooling is a risky experiment with unknown, possibly highly dangerous, long-term consequences. A survey of headteachers (who presumably know a thing or two about education) showed that only 9 per cent agreed with the expansion of religious schools. An ICM poll showed that 64 per cent of people in this country felt that "the Government should not be funding faith schools of any kind".

What is incomprehensibly bizarre and shocking is that at a time when church attendances are at an all-time low, the political influence of the major religions on our government is at its strongest in decades.

Ian Quayle, Fownhope, Hereford and Worcester

The article about Tauheedul Islam girls' school is a refreshing change from the normally very negative stories relating to Islam and Muslims that achieve wide circulation.

What is clear from this example is that Muslim schools cannot be classed as being insular or inward-looking. Muslim schools, like other faith schools, have been receiving excellent GCSE results and foster a tremendous desire to achieve. This, coupled with the strong sense of social justice that drives many of these schools, shows that they are a force for good.

Granted, there will be schools that do not meet the mark, but these schools cannot be seen to reflect all faith schools, which continue to play such a positive role in society.

Fiyaz Mughal, Founder and director, Faith Matters, London WC1

Taking sides in the litter wars

I agree wholeheartedly with Nigel Boddy (letter, 8 November) that: "picking up litter is not just the job of the unemployed. We all have a responsibility to each other and society in general not to litter and to clear up litter."

Unfortunately, it seems that some people object to his suggestion that we should pick up litter and throw it in a nearby bin. Like him I do this regularly and was astounded when, one morning, a lady came running out of her house and shouted at me for putting a discarded can in "her" wheelie bin. I was so shocked that I failed to remind her that the bin belonged to the council, who were good enough to loan it to her for the disposal of rubbish and, at least when it was standing on the street, it was not under her control.

With such attitudes, the fight against litter-louts is unlikely to be won.

Martin D Stern, Salford

Nigel Boddy finds it difficult to understand why people drop litter at all. Quite right.

I am just back home after four weeks in Poland, where I was impressed to watch a young man of 18 or 19 aim a crisp packet at one of the plentiful litter bins in Krakow. He missed. He picked up the packet and aimed again. Again he missed; again he picked it up; and he got it in the bin at his third try. Would you see that in England?

David Boggis, Matignon, France

The dubious morals of MPs

The reaction of some of our MPs to the fall from grace of Mr Woolas is enlightening, to say the least.

Last year, their inability to grasp the basic concept that they should not claim repayment for lavish – or even non-existent – expenses kept us entertained for some time. Now, they struggle with the suggestion that they should not be allowed to lie during election campaigns.

These do seem to be the sort of fundamental issues of right and wrong that I rather hoped they'd have mastered before putting themselves forward as candidates for public office. Or am I being naive?

Mark Ogilvie, Malpas, Cheshire

Ban use of costly consultants

Drafting in a private-sector hit-squad to sort out the public sector is not a clever move (report, 8 November).

Many of the over-spends during the last government were due to private-sector companies negotiating contracts extremely advantageous to themselves at the expense of the taxpayer. There were shockingly wasteful MoD contracts and most PPP and PFI schemes alarmingly over-ran. A vast amount of money has been wasted by mandarins commissioning reports from outside companies because the Civil Service no longer has the confidence to undertake anything on its own. What needs to be eliminated is the huge management-consultancy bill: someone should make sure civil servants are of a calibre to manage their own departments without outside help.

Julia Doherty, Uckfield, east Sussex

Age is no barrier when hiring a car

Herb Short (letter, 6 November), is talking nonsense when he says that people over the age of 70 are barred from hiring cars. At age 71 (having retired years previously after working as a transport planner for three local highway authorities), I have this year hired cars from Europcar in Cambridge, and Avis in Rouen, France.

For both hires I was required to present my driving licence, which clearly states my date of birth in August 1938. I encountered no problems on either occasion and no special age-related conditions or premiums were applied to these hires.

Regarding free countrywide off-peak bus travel (letters, 28 October), in the current economic climate the provision of this for everyone over the age of 60 away from their local area is a sheer waste of taxpayers' money. Nevertheless I will continue to exult in availing myself of this unnecessary handout until it is abolished.

Graham Jellett, Whitley Bay, Tyne and Wear

Scare for Button in Sao Paulo

I was bewildered to hear Bernie Eccleston say that Sao Paulo was no more dangerous than Oxford Street on a Saturday afternoon (James Lawton, 9 November).

He said Jenson Button should have let his attackers have the car. Men brandishing machine guns on the streets of Sao Paulo are unlikely to be in need of a car; they are after the person in the car and that person's ransom value – probably millions in the case of Button.

Sao Paulo is a massive and dangerous city, but even more so if you are wealthy; hence the need for armoured cars and specialist protection.

Doug Sibley, Birmingham

UK Tea Party is well under way

You ask "Could Britain throw a Tea Party as well?" (10 November). You are behind the times. On 11 July the Freedom Association threw a Boston Tea Party in Boston, Lincolnshire when a giant teapot was emptied into the river. This celebration had been preceded by a well-attended meeting addressed by a number of people, including myself as UKIP MEP for the East Midlands.

Following this the Tea Party moved to a fringe meeting at the UKIP conference, where again I contributed.

The Tea Party, UK division, is alive and well.

Derek Clark MEP (UKIP, East Midlands), Northampton

'Abbey' national?

I am getting increasingly frustrated at the many references to Downton Abbey. Most of us living in Scotland (apart from those in Border TV area) have been denied the opportunity to watch this programme, as STV has decided not to broadcast it. Could your writers please be aware that Scotland often has different public holidays and different TV programmes and recognise this in their articles?

Susan Tritton, Edinburgh

Sleep on it

Cameron, Duncan Smith and the Coalition are obsessed with people who lie in bed all day. They insist we need more entrepreneurs. Although ideas are difficult to come by in these competitive, recessive times, I think I've discovered a niche in the market. I'm going to start a bed company.

Philip Moran, London N11