Statins are not wonder drugs, and they can have bad side-effects
Sir: The Government's heart tsar, Roger Boyle, calls for a public debate on statinisation of the population ("All men over 50 should be offered heart pills", 28 July). Such a debate is possible only if the available evidence is clearly and dispassionately set out but, at present, there is incessant hype for the effectiveness of statins as wonder drugs.
The evidence used to justify statin use is based on several large studies, sponsored by pharmaceutical companies and it is well-known that studies so sponsored almost always produce favourable results for the company's drug.
Relative-risk reduction looks much more impressive than absolute-risk reduction, so the studies highlight the reduction of relative risk. In one trial, the relative-risk reduction was 31 per cent, but the absolute-risk reduction was only 2.4 per cent.
In another trial, the relative-risk reduction of cardiac event, not death, is 36 per cent; the absolute-risk reduction of a cardiac event is just 3.4 per cent events per 1,000 patient years of treatment.
The statistical manipulation and selective presentation of the evidence means that properly informed consent will be impossible to ensure.
The view that statins have minimal side-effects is erroneous. As a rheumatologist, I have spent a significant proportion of the past few years seeing patients who have suffered musculo-skeletal ill-effects from statins. Some of these effects have been severe, leading to major disability, and even the lesser effects have led to considerable loss of quality of life.
Even if the incidence of side-effects was as low as some studies have suggested, with such huge numbers facing long-term statin treatment there will be significant statin-induced disease and disability in the population. There are large hidden costs in this aspect of statin therapy.
The only wonder about statins is to wonder why the nation is being urged to take part in mass medication based on such underwhelming evidence.
IAN M MORRIS
CONSULTANT RHEUMATOLOGIST, ROTHWELL, NORTHAMPTONSHIRE
Homes uninsurable after the flooding
Sir: Re your leading article "Questions now the rain has stopped" (30 July). We are insurance brokers, based in the West Midlands. I had to phone a large UK insurer about a client, a victim of the Gloucestershire flooding, who is moving home. The sale was well under way, as was the purchase of the new property, before the flooding.
I asked the insurance company if they would provide buildings and contents cover for the new purchasers, because other companies had refused to quote for them. The insurer said that although they had insured the property for several years, they would consider an application from the new purchasers as new business, and they, too, would decline to quote.
Our client selling the property is moving to a bungalow, 100 yards down the road, which also suffered flood damage. The insurer would not cover this property either. But if our client was not moving, I am sure the insurance company would have offered renewal terms when they became due.
These properties are in a minimal flood-risk area. This type of attitude by insurance companies could cause chaos in the housing market. In this instance, the sale of the two properties will probably fall through, unless suitable cover can be arranged. The contract of sale would be cancelled, with the resultant knock-on effect to buyer, seller, estate agents, solicitors and mortgage companies.
Are these the sort of problems people can expect when trying to buy or sell their properties in these "risky" areas?
NAME AND ADDRESS SUPPLIED
Sir: Clearly, our towns and cities vulnerable to flooding need greater protection. But the solution is not simply higher flood-walls. That would merely add to the misery of outlying villages and agricultural communities, which will be even further submerged.
There are other solutions. To combat local flash flooding, clear the drains and keep them clear. Obvious, maybe, but there is evidence in Gloucestershire of poor maintenance.
Then there is the wider problem of swollen rivers: first, bring back the dredgers (why did they ever go?). This will lower the Severn's riverbed and allow for some, if not all, additional floodwater to stay within the river's course. Second, learn from other European countries that have experienced similar hardship: build alternative channels and flood reservoirs.
Here, in heavily-flooded Longford, north of Gloucester, the local government inspector is still toying with the lunatic idea of building hundreds of new houses. I haven't seen any surveyors in the past few days, but it's not easy doing that kind of work waist-high in water. Far better to take the land earmarked for development and create a flood reservoir which can be emptied by a system of locks into the regularly dredged and lower Severn in advance of a flood: we always have some days' notice before the river overflows.
Sir: I live in the Fens, the lowest-lying land in Britain, and we don't have much flooding here. That is because, like the Netherlands, we have long, straight, man-made rivers which mechanically pump the water out to sea.
Compare this to the flooded Midlands which have meandering, slow-moving, bendy rivers with natural flows. The two are not comparable.
RAMSEY FORTY FOOT, CAMBRIDGESHIRE
It's easier to take the car, not the train
Sir: I wondered as I drove towards Cambridge station how Ruth Kelly was going to induce me to make more frequent use of the train, and improve my carbon footprint at the same time. The station car park was full. The approach road that had awkwardly accommodated up to 100 cars on £4.80-a-day meters had been scalped with no notice. Double yellows, no meters. The planners placed Cambridge station in the middle of a town so packed we are about to be whacked with a congestion charge.
"Where am I supposed to park then?" I asked the attendant. "What would you do if the shopping centre car park was full?" he asked. Of course! If the shopping centre car park was full I would shop somewhere else, and so I drove to Derby, only two hours or so by car, (three to four hours by train).
And as I built up my CO2 miles on the way home, I wondered if anyone had thought of putting Cambridge railway station outside Cambridge next to the motorway where there are plenty of fields for stations and station car parks.
Too much to contemplate for town planners supporting the building of a huge shopping complex and car park in the middle of the city and at the same time promoting a congestion charge for using it. I intend rereading my Catch-22.
Sir: When the railways were privatised, the idea was to introduce competition which would lead to better and cheaper services.
Today there is no competition, because each area has its own railway company. For example, if I wish to travel to London, from Nottingham, I have to buy a ticket from Midland Mainline. Midland Mainline staff told me I have a selection of 28 tickets from Nottingham to London, and 33 from Sheffield to London.
The value you get for your money depends with which railway company you use. A Liberal Democrat survey showed that for £10 the Heathrow Express is the most expensive at 27.06 miles, and the least expensive is Mer-seyRail, which will take you 118.78 miles. There appears to be no co-operation between the various railway companies.
Israel's 'history' a hoary chestnut
Sir: S W Massil (letter, 26 July) reproduces the hoary chestnut of the 1947 UN partition.
The reason why the Palestinians and the Arab states did not accept the partition is because it gave 55 per cent of Mandate territory to the Jewish state, when the Jewish population was less than 30 per cent, and Jewish ownership of land about 6 per cent. The partition was a con job of the Western powers.
But no, this generosity was not good enough. The Zionist jihadis did not accept the partition then and their children do not accept it now.
A Jewish state without Jeru-salem? No thank you. The plight of the Palestinians cannot be blamed on the Arab states's behaviour in the late 1940s.
Can we have a moratorium on printing letters from the party faithful who continue to defend the indefensible, Israel as pariah state?
Children banned at donkey derby
Sir: Am I alone in wondering if those in authority have lost all links with common sense? The news that the Health and Safety Executive is not allowing children to compete in the Llandudno Donkey Derby should not be too much of a surprise, even though there has not been a accident in 39 years.
And for 300 years, the church bells of St Peter and St Paul's, in Cranfield, Bedfordshire, have chimed every 15 minutes, without complaint. Now, newcomers have complained about the bells, and the Mid Bedfordshire District Council has issued a noise-abatement notice forcing the bells to fall silent.
Solutions are simple. If a parent is worried their child may be hurt falling off a donkey, the commonsense solution is not to enter them in the race in the first place. And if you find church bells in Cranfield an irritant, do not buy a property in the village.
Why does authority always give in to the minority, thus spoiling the fun and traditions en-joyed by the many?
Sir: I was shocked and saddened to discover that the International Scout Jamboree will not allow scouts to light fires (report, 28 July). We have come to expect the banning of conker fights and tree-climbing in our increasingly paranoid world but this is surely one step too far.
In June, Steiner schools from across the country and many from abroad, held a three-day Olympic event based on the original Greek Olympics. We all camped, more than 300 children and three times as many adults.
Battling the elements, we built open fires to cook on, many people even making bread ovens. We sat around the fires in the evenings, told stories, sang and met new friends.
Steiner children go out into the world, confident, grounded and prepared for whatever the future throws at them. Should our fossil fuels run out, I wonder who will teach the survival skills that the rest of the population has lost or never learnt?
EXETER STEINER SCHOOL, EXETER
The terrorists of the Woodland Trust
Sir: If BAA obtain their injunction I will no longer be able to travel westbound on the Piccadilly line reading my Broadleaf because I will be liable to arrest and detention as a terror suspect.
But I will be in good company with the many local authorities, government bodies and similar organisations that support the Woodland Trust. Is the next step for BAA to apply to have the Woodland Trust declared a banned organisation?
ANTHONY N BATES
Briefly... Improved participation
Sir: Far from "calling widening participation into question" (report, 26 July), the National Audit Office report on student retention notes that between 1999 and 2000, the sector successfully increased the proportion of students from black and minority ethnic groups, students with disabilities, and students from a background without a tradition of higher education, and improved its overall continuation rates.
PROFESSOR DRUMMOND BONE
PRESIDENT, UNIVERSITIES UK, LONDON, WC1
West of Wales
Sir: I was interested to see Siôn Jones spelling out the differences between England and Britain (letter, 26 July). But I was slightly worried to learn that England now lies to the west of Wales. This is going to add a few miles to our ferry journeys.
Sir: If Shambo the bullock had been a religious icon of the Muslim faith, I can't help thinking the Welsh Assembly would have found a way to keep him alive rather than risk violent opposition.
Sir: I'm glad to hear I saved Sean Cordell (letter, 28 July) the Oxford train fare to see Stella Vine's art. If he and Christopher Clack (letter, 24 July) join forces, maybe a new consciousness might spread: one not dividing eye and mind, form and function, part and whole. This was a theme of my two (10ft) paintings, "Clouds Reflected in Architecture" and "Environmental Patterns", installed in the Royal Academy's restaurant (1979-84). These showed ideas of philosophy, ecology, politics and war, not shown in art before, yet taboo 30 years ago. Plus ça change?
Sir: Even though I have been in (unrequited) love with St Germaine Greer since 1968, your attribution of the saying "revolutions are festivals of the oppressed" to her is silly and displays a sub-GCSE knowledge of political thought. The term goes back at least to Lenin and is symbolic of important traditions in socialist and anarchist thinking. Am sure she would be the first to acknowledge this.
Sir: Has Scotland, all or part, finally achieved independence? Your map of Britain's flood plains (25 July) stopped just south of Edinburgh.
Sir: Those dismayed by the plan for a Thames desalination plant, may help resolve water shortages, by the household males urinating on the compost, thus saving on loo flushes. I find it pleasurable stepping out and keeping in touch with the great outdoors.
BETHESDA, GWYNEDDReuse content