Letters: Today's political battlegrounds

Today's political battlegrounds: civil liberty and the size of the state

Sir: Michael Brown (Opinion, 6 September) falls into the usual commentators' trap of trying to position the parties on a left-right spectrum. This exercise makes about as much sense in today's world as trying to figure out whether Tesco is to the left or right of Sainsbury.

Voters are more interested in finding out whether a party's proposals will benefit them, their families, their neighbourhood (and maybe) the wider community. They may also make a judgement on whether the governing party has delivered on its promises and maintained its integrity.

For example, in Hornsey and Wood Green constituency this year, a sitting Labour MP was replaced by a Liberal Democrat, largely because of a perception that the Government rigged evidence and dragged us into an illegal war and also because the rich seem to be getting richer and the poor poorer. The newly elected Liberal Democrat benefited from the votes of many former Labour supporters as well as former Conservatives. For Brown to posit that Liberal Democrat MPs representing these kind of inner-city seats will not allow their party to be "to the left of Labour", misses the point and fails to recognise where future political debate will lie.

The current and future battlegrounds both within and between parties will be along the spectrum of civil liberties versus authoritarianism and also over the size and shape of the state. The Conservatives have already wobbled back towards defending the individual against the imposition of ID cards, also a matter of great unease for many Labour MPs.

And recent tragic events in America will surely prompt us all to question the current fad for governments to abdicate their responsibility to their citizens by privatising key services in order to create a "smaller state" where no one is in charge and no one is responsible when the music stops.

NIGEL SCOTT

CHAIR, HARINGEY LIBERAL DEMOCRATS LONDON N22

GPs strive to meet patient demand

Sir: Jeremy Laurance fails to grasp the difficulties faced by GPs in trying to respond to rising patient demand ("Why does it have to be so hard to see a doctor?", 8 September). In my 18 years as a GP the number of patients registered with our practice has remained fairly constant, and yet the duration of my surgeries has doubled. Despite expanding our nursing capacity and using other allied health professionals, pressure on GP appointments continues to rise.

This is partly because of more systematic screening and treatment of chronic conditions such as diabetes and high blood pressure, but also because a minority of patients over-use their GPs for complaints that are trivial and self-limiting. In a system where patients determine their need for an appointment, GPs cannot influence demand.

In addition, GPs spend increasing time undertaking tasks such as audit and prescribing reviews that limit our capacity to see patients in surgery. This is a positive change and reflects the generally higher standards of care provided in modern general practice.

Dr Meldrum is correct in asserting that in creating appointments that can be booked on the day, there are fewer appointments available to be pre-booked. My experience has been that increasing our immediate availability has not reduced the demand for pre-booked appointments, and whilst it may appear a "peculiar argument", it is nevertheless true. As the article points out, "if you press the balloon in one place it will bulge in another".

"Putting patients first" is simpler in theory than in practice. I have a responsibility to work in the best interests of individual patients, but also the practice population as a whole. Where there is pressure on resources, we cannot please all the people all the time, and we have a responsibility to achieve the best with what we can provide. Jeremy Laurance's article is simplistic and unfair to a profession that in general provides high standards of care that most of our patients appreciate.

DR NICK FIELD

SHEFFIELD

Sir: Jeremy Laurance makes it all sound so easy. If only it was as simple as he makes out for GP practices to provide every patient with an appointment just when they want it.

Of course GPs have thought of the measures he suggests to free up appointment time - they spend their lives trying out ways to meet their patients' needs. The point he misses is the increasing demand on practices that now pick up work which used to be done in hospitals. Coupled with an ageing population, and the need for longer consultations to deal with more complex health issues, this means that more people want more time to see their family doctor than ever before.

GPs want to work towards a solution which allows them to offer appointments as and when needed. The Government's same day/next day target for all patients has wreaked havoc with practice systems. It's a great tribute to general practice that despite this hampering effect, 70 per cent are still able to offer patients what they want. But it doesn't get away from the argument that it is difficult to achieve, and for some, almost impossible. I suspect most of those 30 per cent of patients who were dissatisfied live in areas with a severe shortage of doctors. It is a capacity issue. Why does it have to be so hard to convince government this is the case?

DR HAMISH MELDRUM

CHAIRMAN, GPS COMMITTEE BRITISH MEDICAL ASSOCIATION LONDON WC1

A city destroyed by decadent cuisine

Sir: Bruce Anderson's vile column (5 September) is just what we New Orleanians needed to hear - our lifestyle caused a Category 5 storm to annihilate our city.

I am currently displaced from my home thanks to Katrina; I am one of the lucky ones, however, as I am receiving the hospitality of friends and relatives. But Anderson's column will for ever change my views our so-called friends and "cousins". If a decadent life style, a thing wholly folkloric, caused natural disasters, I suppose the prurient Japanese need a dose of old fashioned British morality, especially of the royal variety, in anticipation of the next earthquake or typhoon.

And the dig at Creole cuisine was quite comic, given the world-renowned sophistication of the British table. Having suffered through too many nearly inedible British meals, all I can say is, thank God for Galatoire's, a local establishment which celebrated its 100th anniversary by being named America's top restaurant, and for any number of humbler establishments which would raise the level of Britsh "cuisine" by an order of magnitude if they were anywhere in the UK.

Please don't expect my support next time your chestnuts are in the fire, as they so frequently are.

RANDALL L KLEINMAN

NEW ORLEANS

Sir: It would appear from many reports that the richest country in the world cannot or will not look after its poorest citizens either before or after the Katrina disaster.

Given that America has probably more millionaires than any other country, and many of these millionaires are in, or closely associated with, the Bush administration, it seems rather ironic that appeals have now been launched to ask the "ordinary" people of other countries to donate towards the victims. Surely there is more than enough money within America to address the problems.

If not, and I do donate, what assurances would I have that my donation will not mean that the Bush administration has to give less to the victims and therefore continue to spend astronomical sums waging its illegal war on Iraq? Until I have such assurances, the Americans have my sympathy but not my donation.

JOHN MCALLISTER

BELFAST

Sir: Part of the blame for the shambolic start to America's Hurricane Katrina distress relief has been attributed to America's federal constitution, separating the powers of local, state and federal authorities strictly from one another. So much, then for the oft-repeated Europhobe threat of a "federal superstate" (a contraction in terms), with all power concentrated in Brussels.

WALTER GREY

LONDON N3

Guests insulted by British officials

Sir: Mr and Mrs Hereward's experience (letter, 1 September) is awful. No sense of shame seems to reach the officials concerned and one's own good faith seems to be in question. Unfortunately, it is nothing new.

Thirty-five years ago my husband was working at the British embassy in Brussels, where we met an elderly Indian couple, visiting various European countries on their way to England. The husband had played cricket for an English county and then for India. After dinner the old gentleman came up to me and asked "Is it true that immigration officers are now rude to people who do not look English?" I was embarrassed because I knew it was true. He burst into tears and said "I have loved England and regarded it as a second home since I was a boy, and do not think I could bear it if an Englishman was rude to me".

I tried to say that I thought that even an immigration officer would be able to tell an elderly intellectual who had played cricket for Gloucestershire from an illegal immigrant - but I was not confident, and kept my fingers crossed all the next day.

E TENISON

BRISTOL

Fusilier who died for the people of Iraq

Sir: It is ironic that The Independent, which had spearheaded the campaign against the Iraq war, should now shed tears on the death of Fusilier Meade ("The immigrant who died for Britain", 8 September). These are certainly crocodile tears.

To us, immigrants from Iraq and other Arab and non-Arab countries blighted by brutal dictators, the Iraq war was yet another demonstration of the huge cost Britain and the British people had to pay to help us. It is only people like us whose tears are genuine and heartfelt.

We are indeed for ever indebted to the Meade family and others whose sons and daughters were killed or injured in Iraq, Sierra Leone, Afghanistan and elsewhere, hoping that some day we will be able to repay our debt to Britain and the British people.

M B AHMED

LONDON W8

Sir: I'm fascinated to read that "Britain warns of an Islamic backlash if EU snubs Turkey" (8 September) . What did Britain think would happen if it took part in an illegal war against Iraq? Roses fluttering gently from the sky?

The US initiated a war against Iraq: Britain supported it with no worries about "Islamic" feelings. The US supports Turkey joining the EU: Britain worries about Islamic backlash if Turkey cannot join the EU. And the Tories worry about losing sovereignty to the EU!

JOE MCNAMEE

BRUSSELS

Cherie speaks on Islam and women

Sir: Rather than putting her foot in it (report, 9 September), Cherie Blair has put her finger on it.

The oppression of women by Islam, not to mention gays, is a just subject of concern, just as it is in the Catholic and Anglican communities which also practice discrimination against these groups. Yet Cherie's husband prefers to kow-tow to the Islamic community, throwing funds at Muslim schools, giving knighthoods to Muslim leaders and inviting the latter (men, naturally) to take up positions of influence on various panels and campaign groups.

And this is from a government that is legislating to eradicate discrimination against women and gays from UK society, while simultaneously granting exemptions to any and all religions, be they Jewish, Islamic, Christian or whatever, to enable them to continue to practice their primitive bias against these groups.

Cherie is right to speak out.

ALISTAIR MCBAY

METHVEN PERTH

Dignified winner

Sir: May I suggest that the English football authorities pay whatever is required to Andrew Flintoff to teach Wayne Rooney how to win with dignity?

BRANDON ASHWORTH

SHEFFIELD

Sir: Your "beginner's guide to the Ashes" (8 September) described cricket as, "played between two teams of 11 players each, on an expanse of grass called a pitch". The "pitch" in cricket is in fact the area between the bowling creases, or the wickets. The rest of the playing area is described as the outfield or the ground.

JEREMY Q SLEATH

LEAMINGTON SPA, WARWICKSHIRE

World-changing books

Sir: The list of 12 British books that changed the world (8 September) could provoke a lively debate. How about Baden-Powell's Scouting for Boys, the forerunner of scouting, which today has over 28 million members in some 216 countries and territories of the world? The book itself is fourth in the all time "best sellers" list after the Bible, the Koran and Mao Zedong's Little Red Book.

J M TOY

WARGRAVE, BERKSHIRE

Drug experts

Sir: It has been common over the years for retired experts to express the same sort of opinions on drug-law liberalisation as are now being advocated by David Cameron (report, 7 September) - but only after retirement when they can no longer be held to account. It would be useful if a survey were to be done now of the views of retired chief constables and heads of drug squads. I suspect many would agree with Mr Cameron.

DR ROGER JAMES

PORTSMOUTH

Unfair on the old

Sir: Will you please ask Janet Street-Porter ("Our ageist attitudes have got to change", 8 September) to have an admonitory word with Dylan Jones concerning his offensive and ageist observation in the same issue that: "Farce, I always thought to myself, was the province of the stupid, elderly or the uncoordinated".

DAVID MCNAMARA

BEVERLEY, EAST RIDING OF YORKSHIRE

Gourmet dogs

Sir: How astounding that Jack Russell terriers recognise only "dinner" (letter, 8 September). Our recently deceased Cairn terrier knew "breakfast", "Weetabix", "toast", "lunch", "biscuit", "tea", "milk", "dinner", "supper", even "apple" - anything, in fact, to do with food. I think, perhaps we made some failings in our initial training programme.

ROBERT PATERSON

LLANTWIT MAJOR, VALE OF GLAMORGAN