Letters: Perspectives on the Arab Spring

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Bahrain: it's time for the UK to get tough

Now the US has put Bahrain on the UN Human Rights Abusers list, the Government must take a tougher line and threaten sanctions.

To date 1,109 people have been detained and 61 prisoners have "disappeared"; 867 are still detained of whom 77 have been convicted out of the 82 tried.

These trials take place with no defence lawyers and confessions have been obtained under duress, with the prisoner not seeing what they're signing.

Mr Cameron must stop government support for arms which are then used to attack citizens. It's time to change.

Janet Salmon, Richmond, Surrey

As the UK is now regarded as the libel capital of the world I look forward to the Bahraini government suing The Independent and Robert Fisk in the High Court.

In the meantime, if the Bahraini Government wish to have confirmation of the "facts" they present, might it not be sensible for them to open their borders to western media so that proper investigative reporting can be carried out?

In the meantime I prefer investigative reporting to propaganda.

David Kennett, Barry, Vale of Glamorgan

I'm a big fan of this newspaper and I would really like to thank you so much for covering Bahrain; my thanks to all journalists and the administration of The Independent, especially Robert Fisk. We all support you for showing the world the truth.

Khalil Ashoor, Glasgow

Whatever they may think of the commentary from The Independent's Middle East correspondent Robert Fisk, the Foreign Media and Press Information Affairs Authority of the Kingdom of Bahrain (Letter, 16 June) must surely accept that he does at least possess sufficient courage to write his articles under his own name.

Paul Tyler, Canvey Island, Essex

Syria: ICC must issue arrest warrants

The appalling and worsening situation in Syria prompts me to ask why the International Criminal Court has not announced an initial list of around a dozen senior people in Syria who are under investigation for crimes against humanity.

The ICC should also announce preparations for the issuing of international arrest warrants for them. It might focus their minds wonderfully if they were to realise that they may have used their passports for the last time.

Peter Rutherford, London NW6

A chance to revive a demoralised NHS

Your article "National wealth service" (15 June) highlights the logical absurdity of a so-called purchaser provider split where GPs (now to be joined by consultants) fulfil both roles! In addition, it is a failed system that has delivered service benefits that are so modest and accompanied by such bloated financial bureaucracy that it can be argued that more would have been achieved if funding had simply been increased.

Moreover, the systematic replacement of a professional by a financial ethos has resulted in a more dehumanised service to patients and a more demoralised (but ironically often higher paid) workforce than at any time in the history of the NHS.

Managers and politicians need to challenge the assumptions that the values of British business (at a time of limited innovation and relative indifference to customers) have a useful message to the NHS, and that the (hospital) medical profession are "always resistant to change".

The White Paper is long on rhetoric but short on identified problems, but it offers a great opportunity for doctors and other staff to work together – with patients – to restore professionalism and show how much better we can do to identify the core services that patients actually want, to ensure patients are listened to, and to deliver services to explicit quality standards within a defined budget.

A modern NHS requires a re-evaluation of the traditional two-tier duplication of activity between Primary and Secondary Care, with for example: integration across the false divide to meet the QIPP recommendation for Alcohol Care Teams; transparent decisions about who does what in chronic care; and better alignment of care to patient need for conditions like irritable bowel syndrome or coeliac disease, where dieticians, counsellors and support from charities arguably have more to offer than doctors.

C J Hawkey, Professor of Gastroenterology, University Hospital Nottingham

Despite the pause the Government's Health Service reforms remain flawed.

First, they depend on applying treatment before a diagnosis. What is really wrong with the Health Service needs to be ascertained before any reforms take place,

Second, for most of us our main contact with the health service is with our general practitioners, not the hospital service. How does providing the GPs with money to reform other services help to improve general practice?

Andrew Johnson, Former Chairman Southport & Ormskirk Hospital Trust, Lancashire

In "National wealth service" you quote Dr Clare Gerada of the Royal College of GPs: "If you have any system that you can gain financially from making decisions about your patient care, then clearly that is a conflict of interest." My colleagues working between NHS hospitals and Harley Street seemed to have figured this out to their benefit about 60 years ago.

Richard Coker, Professor of Public Health, London School of Hygiene and Tropical Medicine, London WC1

We must be free to choose to die

Tim Lott feels uncomfortable at the prospect of legalising assisted suicide, since he himself once wanted to die and might wrongly have chosen this option had it been legal (15 June).

It is true that tragic mistakes could occasionally be made. But with freedom of choice comes the freedom to make wrong choices.

In any case, if Lord Joffe's Bill to legalise assisted dying for the terminally ill had been passed, Mr Lott would not have qualified, as he was not terminally ill.

Belgium, which allows the assisted suicide also of non-terminal patients, shows how safeguards against abuse may be set up. A doctor must explain fully to the patient the possibilities of palliative care, a second doctor must examine the patient's medical history and confirm the degree of the patient's suffering; and when the illness is terminal, a third doctor must confirm that the request is freely and competently made.

Of course good palliative care can reduce or stop pain. But physical pain is not the only consideration. An inability to swallow or breathe properly could cause considerable discomfort which cannot be relieved adequately with painkillers.

Moreover, a loss of control of bodily functions, total dependence on others, and loss of dignity, may all weigh more heavily on some than physical pain, and for them no amount of palliative care is acceptable.

David Simmonds, Epping, Essex

Tim Lott suggests that the "thin edge of the wedge" argument is convincing. Is he really suggesting that if the law was changed there would be queues around the block for assisted suicide? I saw no queue at the death house in Switzerland.

Opting to kill yourself requires a lot of courage, more than most of us possess. Having dispensed with the religious arguments, what moral right have we to stop people ending their lives? None. So let's get on with it and show some enlightenment for a change.

John Verity, Abenhall, Gloucestershire

In making his argument about assisted suicide, Dominic Lawson (14 June) cites research by the charity Scope which highlights disabled people's fears of "assisted suicide". The poll in question, of 500 disabled people, conducted by ComRes stated "helping another person to commit suicide is currently against the law" and then asked "how concerned or otherwise would you be about a change in the law to legalise assisted suicide?"

As an advocate of assisted dying for terminally ill, mentally competent adults, if asked that question I would have stated that I was concerned about a change in the law to legalise "assisted suicide" (which would make assistance to end their life available to people who are not terminally ill).

There may be some people who wish to legalise assistance to die regardless of the circumstances, but I suspect, and evidence suggests, that they are in the minority. The overwhelming majority of the public, as evidenced by every opinion poll on the issue, support giving people greater control over their deaths in the last days and weeks of life.

Mr Lawson justified this deliberate widening of the debate by concluding that the "intended beneficiaries" of a change in the law are the "physically incapacitated" as "the fully able-bodied need not call upon others to kill us". Obviously Mr Lawson is privy to information that I do not share, because I am unaware of a way to help someone end their life humanely and with dignity without the assistance of healthcare professionals.

Who is stoking fear amongst both disabled and non-disabled people: advocates of assisted dying or opponents of assisted suicide?

James Harris, Director of Communications, Dignity in Dying, London W1

Could I add another element to the "right to die" debate?

A young, recently qualified nurse of my acquaintance has been upset by the treatment of an elderly patient. He is very frail, in his eighties and has no family apart from an older sister.

Twice in as many days he has suffered "fatal" heart attacks but fortunately the hospital's crash team has been able to resuscitate him.

Why do doctors believe that they must save patients regardless, and how does this man exercise his "right to die"?

Mike Stroud, Swanswea

Help for the homeless

Like many of your readers, I am shocked and saddened that I still see people living on our streets ("Where did you sleep last night?", 9 June). I am more shocked when some people seem to accept that it must always be so.

Despite the need to take tough decisions on public spending, we have deliberately protected funding for tackling homelessness at £400m over the spending review period and delivered 99p for every pound of Supporting People funding that councils previously received.

One of my first tasks as Housing Minister was to establish the cross Ministerial Working Group on rough sleeping that includes tackling the root causes of single rough sleeping. We will be issuing our first report this month setting out the specific measures that Government will take. The Housing Benefit budget has jumped by 50 per cent in the past five years – to tackle to nation's budget deficit properly we must rein in this sort of spending that has got utterly out of control. The reforms are essential to creating a fairer system.

We recognise they can't happen overnight, and that's why we are providing additional funding to councils to allow them to smooth the transition to the new benefit levels, protect people in vulnerable situations and help prevent homelessness.

Grant Shapps MP, Minister for Housing and Local Government, London SW1

Our independent library is thriving

Helen Dymond (letter, 8 June) is right to say that local councils have ample scope to protect library services and the jobs of the experienced, professional librarians that help customers to use them.

My own local library at Upper Norwood is unique, being the only independent, jointly funded "stand-alone" public library in the country, separate from any individual council library service or corporate support.

Publicly funded by Croydon and Lambeth councils, its total costs are around 50 per cent less pro-rata than their own library services. This is the direct result of it not being locked into the expensive, inflexible and monolithic support-service contracts that are commonplace in corporate library services.

If the Upper Norwood Joint Library is able to offer a fully inclusive, cost-effective and popular library service through autonomous, efficient and decentralised self-management, so can others.

John Payne, Chair, Crystal Palace Community Association, London SE19

A Biblical take on privacy laws

The seekers of "super-injunctions" are using the law to enforce a supposed right to have their misdemeanours kept secret. The supposed "right to privacy" is based on the assumption that a clear line can be drawn between public and private behaviour. This is almost certainly not the case.

Consider the Ten Commandments. Their intention, clearly, is not to regulate personal morality but to outlaw forms of behaviour which are deemed reprehensible because of their public effects. Killing, lying, stealing, adultery, spreading lies ("false witness") and coveting your neighbour's possessions are proscribed not because they are injurious to an individual moral's health but because they threaten the cohesion and stability of society as a whole.

If Hebrew goat-herders could understand this, it is not to our credit that we seem to have forgotten it.

Roger Jones, Fullerton, Hampshire

The lie about foreign students

The Government and UKBA have found a new justification for their dismantling of the student-visa system. We all know about statistics and lies and can of course appreciate how the government and UKBA have to use the information at their disposal, but it is increasingly shameful that in defence of policy they throw in unsupportable claims. Damian Green said: "It is not unreasonable to assume that jobs not taken up by migrant students will instead be taken up by British workers" (report, 13 June). The head of temporary migration at UKBA has claimed exactly the same thing – "if you don't think these [foreign students] take jobs away from British people just ask an unemployed British graduate".

The truth, of course, is that foreign students are usually the ones cleaning offices at 4am, or serving coffee or beer in part-time jobs. British graduates can now, and always have been, able to easily apply to do those jobs. That they show little inclination to do so says more about them than foreign students.

David Wilkins, London W1

Onward cliché crusaders

Pauline A Littlewood (letter, 14 June) is concerned about the overused adjective "iconic", so how about that other overused word "impact" as a noun, verb, adjective and whatever else? The lovely words "effect" and "affect" have virtually disappeared in favour of "impact" and the ugly "impacted on".

Bill Evans, Ruthin, Clywd

Oh dear, how could John Rentoul (14 June) give us such a welcome iconoclastic piece on the abolition of clichés and use that awful tautology "Or, alternatively" in the penultimate paragraph?

Don Shearwood, Romford, Essex

I find that the amazing overuse of the adjective "iconic" is incredible.

William Roberts, Bristol

Examiners' errors corrected

Susan Taylor raises the subject of errors in Multiple Choice Questions (letter, 15 June). When setting MCQs, one way to avoid errors is to ask candidates to indicate any options which are considered to be correct. The options should include "none of these".

The marking scheme then has to take into account candidates wildly ticking by penalising incorrect responses. At a stroke the examination is made harder and the chance of red faces at the examination board is reduced.

Peter Erridge, East Grinstead, West Sussex

Party time

In his article on post-graduation student celebrations (16 June) Tony Bonnici quotes an organiser: " 'It's seen as a right of passage,' she explained." A careless error, I thought – but on reflection, perhaps a rather useful neologism, nicely capturing the expectations of the young.

Mark Ogilvie, Horncastle, Lincolnshire

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