Letters: Preventative medicine

'Preventative medicine' is a misnomer that ignores realities of life
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The Independent Online

Sir: Your leader is correct in its guarded response to the latest enthusiasm for screening ("There is only one real way to improve public health", 8 January), but an underlying problem with preventive medicine as a whole lies in its name, which promises far more than it can deliver.

Very few medical interventions actually prevent disease, immunisations being a rare example of ones that do – they merely modify the progression of disease risk factors. So the statins and aspirin taken to "prevent" cardiovascular disease in fact delay our heart attacks, admittedly sometimes long enough to allow another illness to carry us off. This does not mean that such efforts are without value for the individual, but we all have to die and it is likely that before we do so we will become ill, and in that period we will need a "National Illness Service".

When setting up the NHS, Aneurin Bevan thought that as the nation got healthier the costs would fall. I thank such naiveté, as it was necessary in order to set up the NHS, but the foolishness of the current government's actions in diverting resources away from the sick and towards the well, on a false hope of eternal health, ignores the realities of life and betrays both current and future patients.

Dr Andrew Green

General PractitionerBurstwick, East Yorkshire

Sir: Two years ago this month, my husband Andrew died suddenly of a heart attack in the night. He was 64, ate well, was slim and fit, and never smoked. He had spent years helping to exploit the promise of biotechnology to fight disease.

How sad that Gordon Brown's desire to focus on preventing the diseases that claim people such as my husband who are not easily recognisable as "at risk" should be met with griping from the British Medical Association ("Doctors criticise PM's prescription for the NHS", 8 January).

Doctors should embrace these plans, help to introduce better services and deliver improved healthcare so that couples like us are not prematurely pulled apart. If Brown's "headline grabbing" stops one other person feeling the loss I do, then he should be praised to the heavens.

Angela Davidson

Clifton, York

The safe disposal of nuclear waste

Sir: The nuclear waste disposal problem (leader, 11 January) has been solved by scientists working at the Argonne National Laboratory in the US, who have demonstrated a technique called "pyro-processing" that involves electroplating the dangerous radioactive isotopes on to a cathode and then using the cathode in a fast reactor. With this technique, we could produce electricity for hundreds of years to come simply by burning up our existing waste.

Pyro-processing does not involve separating plutonium from the other actinides and hence does not present a risk of fuel being diverted to nuclear weapons. Fast reactors gradually shut down when they become hotter (due to Doppler broadening of reaction cross-sections), thereby making them inherently safer than conventional PWR reactors. These reactors also can be used to produce copious quantities of hydrogen for transport by using a catalytic process.

The technology has been demonstrated on a small scale, but to put this technique to work would require a push from government because of the initial set-up costs of the first full-scale system. Private industry isn't going to take this route because it is more expensive in the short term.

If the Government insists on going to industry for a cheap solution (that is, PWR reactors and no pyro-processing) instead of taking this smarter approach, then nuclear power will remain unpopular with the public and we will fail to gain the tremendous benefits that are possible from widespread adoption of nuclear technology.

Simon Johnson

Farnham, Surrey (The WRITER IS A FORMER reactor physicist)

Sir: In your leader "A test of the Government's environmental credentials" (4 January), you ask, "Why is there no right for households to sell domestically generated power back to the grid, as exists in numerous other countries?"

In this ordinary bungalow, now entitled the John D Anderson Solar Power Station on our documentation, we receive 9p from Good Energy for every kWh generated from the photovoltaic tiles on our roof, even if we have used the electricity ourselves. From 1 October 2007, Good Energy has paid this amount, having doubled the previous payment. This is funded from the Government's Renewable Obligation Certificates. So there may be no "right", but there is certainly the opportunity to sell homemade electricity to the grid.

The Germans, it should be noted, pay four times the average generation rate per kWh to householders.

John D Anderson

Shipley, West Yorkshire

Sir: There is one energy-saving measure that could be adopted immediately; it would ensure that nearly all of us contribute, would help preserve dwindling oil supplies while we search for alternatives, and would help the balance of payments as well as individual pockets. In 1973, at the time of the first oil shock, the US introduced a national speed limit of 55mph to save on imported oil and enforced it for several years.

Most cars are at their most efficient at this speed, as is demonstrated by the mpg information attached to advertisements for new vehicles. Lower speed limits might mean that it takes longer to reach your destination, but the winners will be all of us, with lower fuel consumption, lower emissions and safer roads.

Dr Chris Burgess


Not every problem is a 'mental illness'

Sir: It is not at all "obvious" that comedians used humour as a way of thriving in their childhoods ("Why being funny is no joke", 12 January). It is pop psychology. Nor can the high incidence of mental illness in English-speaking nations be used as evidence of the importance of early nurture and social processes.

The term "mental illness" can be applied to a huge spectrum of real and imagined disorders, and English-speaking nations share a large literature devoted to whingeing and to the discovery of supposed or actual childhood traumas. Far from being helpful in making sense of our lives, when this gets combined with a Judaeo-Christian tradition in which Adam blamed Eve, and Eve blamed the serpent, it leaves us forever prisoners of our past.

I do not doubt that genes, parental attitudes, and the stream of events and contingencies that we experience all play a part in making us what we are. But at some point in our lives, we reach an age at which we have to take responsibility for our own actions. Part of taking charge of our lives may be a bit of soul-searching or guilt when things go wrong. Painful perhaps, but surely it's better than going through life blaming our parents or partner.

When you put yourself in charge of your life, you always have the option of lighting a candle instead of complaining about the darkness.

Dr Les May

Rochdale, Lancashire

It needs to be easier to set up a school

Sir: Professor Alan Smithers' observation in "Late baptisms soar as parents chase Catholic school places" (12 January ) that faith schools do better in exams because they can be more selective over their pupil intake – rather than because of their faith status – has some resonance and is backed by recent joint research from the Institute of Education and the LSE, which found that religious schools in London are educating a smaller proportion of pupils eligible for free school meals and have more affluent intakes.

There are too few good state schools to satisfy parental demand. Most of the best state schools have some form of religious affiliation, and are at least partially selective. This forces many parents to be deceitful in order to secure a place at a good school. The solution to the problem is to make it easier to set up schools – to free up the supply side. If parent and community groups or not-for-profit organisations were allowed access to state funds to set up schools on the same basis as faith organisations, providing they meet regulatory requirements, then choice would improve and standards would rise.

Moreover, it is demonstrably inequitable that in a secular society faith organisations are given easier access to public funds to establish schools compared to other organisations, including those specialising in education.

Opposition parties now seem committed to supply side reforms, so the ball is now in the Government's court.

Patrick Watson

London SW8

Arts Council must release Lottery cash

Sir: Terence Blacker criticises Arts Council England's use of government funds (Opinion, 11 January), but it is its use, or rather non-use, of Lottery funds that is of greater concern.

Arts Council England has £150m of Lottery funds unused in its bank account. This surplus is more than its total Lottery spending in the last year.

I have been fortunate enough to work with Sir Thomas Beecham, Wilhelm Furtwangler and many great singers. Their examples taught me that artistic excellence does not come easily or cheaply, but requires years of dedication to growing emotional awareness. Arts Council England must begin its commitment to excellence by making a full commitment of its Lottery funds.

Denis Vaughan

President, Council for the Advancement of Arts, Recreation and Education, London WC2

Sir: David Lister writes of the Arts Council's dealings as "opaque, enigmatic and unaccountable" (The Big Question, 11 January). Having some years ago witnessed the exemplary manner in which the Arts Council's New Play Committee was chaired by John Bowen, who, like the rest of the committee, was a professional writer serving as an unpaid member of one of the advisory panels, I suggest that the Arts Council would be less unaccountable, and more in tune with the concerns of artists, if those panels were at once reinstated.

Charles Lewsen


Anne Frank musical: it's been done before

Sir: Your story about the new Anne Frank musical contains a number of errors (12 January). It states that "The moving tale of Anne Frank's life has... never been made into a musical."

In October 1985, Yours, Anne, a musical based on the diary of Anne Frank, opened in New York, and has since been produced in many theatres in the US, as well as other parts of the world. In fact, Jeffrey Wainwright, writing in The Independent, called the 1990 production by the Library Theatre in Manchester "a creditable and ultimately moving piece".

Further, the article refers to the Anne Frank Foundation as if it was a single organisation. In fact, there are two organisations: the Anne Frank Stichting in Amsterdam, which runs the Anne Frank House and offers educational programmes throughout the world, and the Anne Frank-Fonds in Basel, Switzerland, which owns and controls the rights to the diary. Yours, Anne is the only musical to have received permission from the Anne Frank-Fonds to adapt the diary.

Enid Futterman

Craryville, New York, USA

Fight back the tears

Sir: If American politicians really are queuing up to burst out crying ("Pass the onion: celebrity cry babies", 10 January) they'd better be careful. What Esther Walker forgot to mention was how, also in New Hampshire, Ed Muskie's presidential hopes abruptly ended in tears in 1972.

Kate Francis

London NW8

Blasphemy 'offences'

Sir: It may be as you say that no one has been imprisoned for blasphemy since 1922 (leader, 10 January), but in 1977, Gay News and Denis Lemon, its editor, were successfully prosecuted under the blasphemy laws in a private action brought by Mary Whitehouse. The "offence" was to publish a poem about the love of a centurion for Christ at the Crucifixion. Lemon was given a nine-month suspended jail sentence. Perhaps, though, it strengthens your case against these laws that zealots such as Mrs Whitehouse can use them to pursue their personal crusade against freedom of speech.

Robert Scantlebury

Chapel-en-le-Frith, Derbyshire

Moles growth

Sir: The reason for the increase in the mole population (letter, 3 January) is simple and straightforward. The main method of mole control was until recently the use of strychnine-baited worms. It is no longer possible to obtain permits to purchase and use this poison. Trapping, the alternative control method, is time-consuming and requires considerable skill. There is little doubt that we shall see a significant increase in mole populations, accompanied by an increase in the number of sheep and cattle deaths from diseases caused by silage contaminated by earth during the harvesting of the grass.

Ian Rae

Nantgaredig, Carmarthen

Public-sector salaries

Sir: You commend the Government for its decision to reduce the real-terms salaries of public-sector workers (leading article, 9 January). However, the Government is primarily to blame for this situation. It recklessly built up a huge deficit during exceptionally favourable economic times and is now punishing workers in the public sector for its serious mistake. It is not clear to me that this is either commendable or defensible.

Prof Michael Eysenck

Department of Psychology, Royal Holloway University of London, Egham, Surrey

High street blues

Sir: So, high street retailers suffered poor December trading figures. Perhaps if they hadn't been trying to flog their Christmas stock at inflated prices since early August they'd have enjoyed a more profitable festive season.

Terence Roy Smith

Biggleswade, Bedfordshire

A climate change proof

Sir: Several correspondents have written to declare that daffodils blooming in early January are proof of global warming. Forget the daffodils. I have more conclusive evidence: Marks & Spencer in the City of London is already selling "Easter novelty chocolates". Spring is here and it's only the second week of January.

Philip O'Donoghue

London N10