Letters: The elderly

The elderly need practical help if they are to age gracefully
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The Independent Online

Sir: My husband and I celebrated our 75th and 77th birthday this week, and are conscious of the problems facing us (Jemima Lewis: "I've seen the future in my grandmother's plight", 13 October). Our children live overseas, so when we need help we shall be entirely dependent on our diminishing savings, or the generosity of government and/or local authorities

But we are angry that little if anything is being done to help us – and thousands like us – prepare for the future. We do our best. We eat sensibly and watch our weight, we take omega3 and glucosamine every day at our own expense, and walk when we can, despite our aching joints.

A recent knee replacement left my husband with even worse pain because of muscle shrinkage during the years of waiting. In Australia, physiotherapy would have been offered before and after this operation. The NHS in our area offers nothing but painkillers. They do not work: my husband is paying £80 a week for acupuncture and other treatment. The next problem facing us could be Alzheimer's. I had intended to celebrate my three-quarters of a century by learning Italian but this year, for the first time, North Somerset Council offers pensioners no concessions for evening classes. So three terms of one class a week would cost me more than £260. Thank God (and The Independent) for the daily crossword puzzle and the local library.

Some realistic and practical help in "growing old gracefully" would surely be of benefit not only to the ageing millions, but to the country in the long run.

Margaret Spivey

Clevedon, North Somerset

Sir: Jemima Lewis's article drew me in because I also have three close relations (two parents and mother-in-law) creeping towards decrepitude and I recognise the sadness of seeing once-lively and capable people become confused and helpless. But I can't quite understand what she means about the saved money being "plundered" for home help and the proceeds of the house sale "sacrificed" for a care home. I thought that's what rainy-day money was for and that was why we save: for our old age.

It seems many people feel the older generation's savings are for them to inherit. I see nothing wrong with each generation standing on its own feet. If elderly people want to help their children financially why not give it freely when they are alive?

And if Jemima's selfless aunt deserves reward for her sacrifices in caring for her mother then she should be paid a wage out of her mother's savings. She may well receive the state attendance allowance already.

In any event, with so many living into their 90s the offspring will be retired themselves long before they see the money.

Tessa Howard

Bridgwater, Somerset

Wealth does not always mean health

Sir: The UK's poor health record was explained years ago, by, inter alia, the long-term Whitehall study of 17,000 civil servants ("Unveiled: radical prescription for our health crisis", 23 October). Age for age, junior grades had three times the death rate of senior grades. Other research here and around the world showed similar patterns in other developed countries, that wealth means health. But America, per capita the world's wealthiest and highest health spending, has worse death rates than some countries with half its income. Within a country, the wealthiest are healthiest, but wealthiest societies are not the healthiest societies.

This anomaly is explained by detailed epidemiological and medical research, published by the BMJ, HMSO, Quarterly Journal of Economics, various universities, European Journal of Public Health and American Journal of Public Health; the list is endless.

The usual suspects, including diet, heredity and poor housing, were found to be of least importance. What dominates is social stress, most damaging where income inequality is greatest. Increased inequality is associated with increased risky behaviour, including excess indulgence in food, drugs, tobacco, alcohol, careless sex and work.

Social stress does other damage. UK teenage pregnancies are five times those of the least unequal societies, twice those on mainland Europe; America, most unequal, has seven times. Violent crime, most reliably recorded, is highest in the most unequal societies. In the US, the homicide rates correlate with income inequality, with a 10-fold difference between the worst and the best. Size for size, the US prison population is seven times ours, and we are the highest in Europe.

Bill Hyde

Offham, Kent

Sir: I read with some bemusement your front-page article about the nation's "health crisis", a crisis which on closer inspection consisted of only one problem: that the UK has the highest rate of obesity in Europe.

To put this in perspective: life expectancy is at an all-time high and continues to increase at an unprecedented rate. Smoking rates have been in steady decline for decades. Deaths from infectious diseases have been all but eliminated and the incidence of heart disease is falling rapidly. A child born in the UK today can expect to live a longer, healthier life than if he or she were born at any other point in history. In the context of these historic improvements, any negative effects of the so-called "obesity epidemic" pale in insignificance.

Our modern lifestyle is far from perfect and there is no doubt many of us could stay in better shape, but we should remember that there is plenty of good news as well. As a nation, we have never been in finer health, and the situation continues to improve. We should not distract ourselves from this overwhelming positive trend by declaring a "crisis" whenever we find a statistic which depicts us less favourably than other nations.

Ed Waddingham

London SW2

Sir: Professor Julian Le Grand's proposals to halt the health crisis facing this country do not go far enough. The very ethos on which the National Health Service operates, which is, "you fall sick and we will give you a drug to cure you" needs to be overhauled. Individuals must be made to take responsibility for their bodies.

In the Indian Ayur Vedic system, for example, the patient would be expected to follow a strict dietary regime prescribed by the doctor. The patient is told in no uncertain terms that he has to take steps to cure himself. Diet plays a very crucial role in one's physical and mental well-being and instead of just promoting more fruit intake, a meat-free vegetarian and vegan diet should be encouraged. In survey after survey vegetarians and vegans are found to be healthier and less of a burden on the NHS.

Nitin Mehta


Sir: The interventions illustrated on your front page of 23 October – licences for smokers, compulsory exercise hours for large firms, letters to parents of fat children – are all interesting wheezes. But before we inflict them on anyone, let's find out what we already know, and whether the benefits will outweigh the costs.

A workplace exercise trial in the late 1990s, for instance, found only one change: a deterioration in the "work planning" of the intervention group; hard cheese for the nurses and nurses' aides exposed to the intervention, and possibly for the geriatric patients in their care.

By all means let's be creative, but unless we draw on what we already know, and add to it, we will be carrying out what are, in effect, untested experiments with the potential to widen inequalities in health and do more harm than good. Good intentions do not always predict good outcomes.

Helen Roberts, Professor of Child Health, David Gough Professor of Evidence-informed Policy and Practice, Institute of Education, University of London, Rodney Barker, Professor of Government, LSE, Professor Sir Iain Chalmers, James Lind Library, Oxford, Professor Trevor Sheldon, Deputy Vice Chancellor, University of York

Eritrea's record of tyranny

Sir: Your report on violence in Ethiopia (17 October) is disturbing, but the human-rights situation in neighbouring Eritrea is hardly better. Eritrea routinely locks up opponents and journalists. Reporters Without Borders ranks Eritrea the worst country in the world for press freedom.

Tensions between the two countries are increasing rapidly and the prospect of another disastrous war in the Horn of Africa is looming in a region that is a breeding ground for terrorism. Gordon Brown's rose-tinted view of Africa, coupled with an apparently boundless desire to shower "aid" unconditionally on Africa like confetti, seems to achieve little for Africans but bolsters the tyrants who oppress them.

Dr Charles Tannock MEP

(Conservative, Greater London), Brussels

Ban on batons in youth-justice system

Sir: I was disappointed to hear that the government is reviewing the ban on the use of batons in the youth-justice system (report, 22 October). The UN has already criticised this government's failure to comply with some of the most fundamental clauses of the Convention on the Rights of the Child, with the physical restraint of child offenders being a particular area of concern. Such violent restraint has contributed to the death of child inmates on several occasions.

The introduction of physical methods of tackling violent behaviour in these institutions not only violates further the rights of these children, but contributes to an atmosphere of violence and confrontation detrimental to their rehabilitation.

The aim of the youth justice system should not rest in securing the young offender, but in his or her re-education. Unfortunately, if the government reverses the baton ban, they are pushing this aim further down the agenda.

Mark Oaten MP

House of Commons, London SW1

Patient care in Cornwall

Sir: Your article naming the Royal Cornwall Hospitals NHS Trust as "the worst performer" (18 October) failed to make clear that the Healthcare Commission rated the Trust as "weak" on quality of services on the basis that it could not demonstrate compliance with the relevant Standards for Better Health (many not directly related to the quality of clinical care).

Your profile implied that clinical staff were of suboptimal quality, and that applicants were not attracted to the Trust. You have no evidence for these assertions, which are misleading. Clinical standards in the trust are subject to continuous benchmarking through many routes, including local cancer networks and specialist society databases.

To accuse the trust of being a "comfortable backwater" may have some relevance when applied to the management practices in the recent past, but certainly does not apply to clinical practices, which are frequently more advanced than those in many London teaching hospitals.

For 10 years the Trust has been at the forefront of vascular surgery, introducing new techniques to the NHS in Cornwall long before patients elsewhere were able to access them. It has also played a major role in the development of the Peninsula Medical School, and many of my clinical colleagues in other specialties have also developed services of the highest clinical quality, despite the limitations of geography and finance that affect Cornwall.

Kenneth Woodburn

MB ChB MD FRCSG (Gen) Consultant Vascular Surgeon, Truro


Vanunu's plight

Sir: CIA renditions may date from 1995 (report, 22 October), but what about the rendition of Mordechai Vanunu in 1986 from Rome for revealing Israel's nuclear secrets? After 18 years' imprisonment he may face a further sentence for speaking to journalists, and is unable to leave Israel as he wishes.

Raj Kothari

Bridport, Dorset

Monkey business

Sir: It seems strange that the elephants of Amboseli National Park are the first animals to be scientifically observed exhibiting differing behaviours towards humans in different clothes (report, 19 October). In the late 1990s, my brother-in-law, then a veterinary surgeon with the World Wildlife Fund in Kenya, said women working in the fields near Lake Nakuru National Park were wearing men's clothes to ward off foraging baboons. The baboons had learnt that men could throw stones further and with far greater effect than women and so kept their distance where they saw men at work.

Peter Coghlan

Broadstone, Dorset

Armenian troops

Sir: The "Armenian terrorists", allegedly trained by the British in Cyprus during the First World War (letter, 20 October), were in fact Armenian survivors from the horrific genocide perpetrated by the Ottoman Turks, who were trained there before enlisting in the Egyptian Expeditionary Force. As part of the Légion d'Orient, they saw service at the battle of Arara (near Nablus) on 19 September 1918. General Allenby, their overall commander, wrote thus: "I would bring to notice the good fighting qualities shown by the newer units. These include the Armenian troops of the Légion d'Orient."

Christopher Walker

London W14

What is the BBC for?

Sir: Is it time to think radically about what we want from our BBC, ie: what services should be licence fee-funded, and whether others should be made available on a subscription-only basis. I propose that we ring-fence news, current affairs, and factual programming, plus national events and a certain allocation towards each programming sector. The rest should be funded through subscription. The benefits could be huge. If areas such as sport were able to obtain more funding through subscription, this may enable them to win back major events for coverage.

Nigel Cubbage

Merstham, Surrey

Dentistry crisis

Sir: As a steward at the National Trust's Sheffield Park Garden, I guided members of the International Dendrological Society. I said I was no plant expert, merely knowledgeable on the planting at the property, and that I was a retired dentist. The rejoinder from Tony Kirkam of Kew was that we were in the same business: they extract, fill holes and do root treatment. Readers without a dentist might search for a dendrologist rather than an odontologist (The Big Question, 16 October).

Peter Erridge

East Grinstead, West Sussex