Time to decide what kind of EU we want, Help Africa keep its doctors and others

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The Independent Online

Now is the time to decide what kind of European Union we want

Now is the time to decide what kind of European Union we want

Sir: Now that the French have declared the European Constitution a dog's breakfast, let us take this opportunity to blow away the smokescreens and frame our ideas about Europe with greater clarity.

A common market without a common currency is a sham and a genuine common market requires some harmonisation of taxation, interest rates and working conditions - one part of the market must not be able to compete unfairly with another. Trade relationships with the rest of the world, policy on global warming and, perhaps, transport are also issues for the centre. The rest of the decisions can be taken nationally or even better, locally. Although we might decide, with other nations, to cede further powers to the centre, it would depend upon how far the people of Europe wanted to go along the road from common market to superstate.

Are the people of Europe purely interested in a better standard of life or are they more concerned to become the dominant power in the world? Can a common market with huge disparities in wealth function properly and what can be done if this situation needs to be remedied? How do we decide about new members?

These are not matters for the politicians but for the people. Therefore, a successful common market requires robust, open democracy. It is the duty of the European Union to fulfil this need.

If we leave, the future looks bleak - we are a small offshore island that no longer has an empire. If we stay, we must embrace the EU wholeheartedly. We should use our presidency of the EU to bring clarity to the whole enterprise and then decide whether we are in or out. Unfortunately, I fear that Mr Blair is, as always, too preoccupied with his own agenda.



How to help Africa keep its doctors

Sir: In your report of 27 May on western countries employing health workers from overseas you have highlighted an important issue for many African countries. We are both NHS doctors who have just returned after two years in western Kenya. After this experience we see many ways of assisting Africa's gross shortage of doctors, but just moving away from professional poaching will, in itself, have little effect.

There are several factors influencing medical emigration from Africa, not least that many have to independently finance their own undergraduate and postgraduate training. This support will often come from wider family who then, not unreasonably, will expect some return on their investment. What better way to achieve this, and have a professionally more satisfying career, than sharing the riches of the West?

While there will always be a great demand for well-trained specialist graduate leadership, why is there not more emphasis on the place of the "doctor" who is trained for local requirements but who does not have easily marketable credentials? The "clinical officer" grade has been a well-established role in Kenya and many other African countries for decades, in both community and hospital care. Their initial intensive three-year training is modelled on the traditional five-year university medical course and when qualified they carry much the same clinical responsibilities that a "medical officer" would, if available. With further postgraduate training they can specialise in many areas including obstetrics and anaesthetics. African medicine would collapse without them.

Perhaps Europe could repay its medical debts to Africa by dedicating some of the promised billions to not only sponsoring in-country specialist training of graduate doctors but also to enhancing the development and expansion of clinical officer training to get full advantage out of a role which costs less and, at the moment, the West cannot poach.




Sir: Your article "Medical staff quit for the West" (27 May) highlights an issue that is critical to Africa's future. The answer is not to ban health workers from seeking a better life abroad, but to give them a future at home by increasing aid to invest in Africa's health systems.

The UK alone has saved an estimated £65m in training costs by recruiting overseas. That amount, and more, should be invested in poor countries so they can fund desperately needed clinics and hospitals and pay decent salaries. Instead, only one aid dollar in eight currently goes on health, and western governments do not provide the guaranteed, long-term financing needed to properly fund health workers' salaries.

Aid should also be used to cover the cost of getting rid of fees for health care in poor countries, a move which would have prevented many of the agonising cases described in your article.



Freedom to differ over Israel's history

Sir: Oren Ben-Dor, an academic of Israeli origin, was not happy with the AUT vote to repeal its decision to boycott two Israeli universities, and calls for an academic boycott of all Israeli universities (Opinion, 30 May). The reason: Israel curbs academic freedom by preventing a debate on the Palestinian Nakba of 1948.

These curbs exist only in Ben-Dor's imagination. No Israeli academic, right or left, is restricted in his field of research or in reaching his own conclusions. Every Israeli university has its share of extreme left-wing academics who question accepted wisdom, without any limitations on their academic freedom.

Ben-Dor's problem is not academic freedom, but the fact that most Israeli academics do not share with him the Palestinian narrative about 1948. They think that the Nakba was a result of the rejection of United Nation's Resolution 181 of 29 November 1947, which called for the establishment of two states, one Jewish and one Arab. In the war that followed, the Arabs of Palestine, together with five Arab armies, were set to perform ethnic cleansing of the Jews. Fortunately they did not succeed.

I hope that if Ben-Dor, together with Sue Blackwell, try to raise the boycott issue at the next meeting of the AUT, British academics will reject it again with an overwhelming majority.



Sir: As the great-grandson of Sir Leon Simon, let me assure you that I believe that the world would be a far better place if the Balfour declaration which he helped draft ("A scrap of paper that changed history", 26 May) had never been drafted.

The fact that antisemites such as Balfour (and, later, antisemite evangelicals in the Bush administration) threw their weight behind the creation of Israel just goes to show that it was never in the interests of the Jewish people.

On the contrary, it was in the interests of Western imperialism to have a colonial settler state in Palestine, one that is wholly reliant on Western aid (military and economic) and that is wholly scared of the people who surround it (who were forcibly evicted from their homes in 1948). And it was in the interests of Western rulers to divert Jewish struggles away from anti-racism and social justice and towards the ethnic cleansing of the Palestinian peoples.

More and more Jews are coming to see what my great grandfather failed to see, that the only just solution in the Middle East is a Palestine in which Jews and Muslims, Arabs and Europeans, live alongside each other with equal rights and an equal stake in the state; a solution in which the Balfour declaration is finally put to rest.



Gehry plan provokes horror in Hove

Sir: I was upset to read your article about Brad Pitt and Frank Gehry ("When Brad met Frank and moved to Brighton", 26 May) because of the huge inaccuracy which ran throughout the article. Frank Gehry's design for the seafront flats is not intended for Brighton, but for Hove (we are actually the City of Brighton and Hove, even though the council would love to drop Hove from the title) and this has enormous implications.

The character of Hove is completely different from the more brash and cosmopolitan Brighton, being far more "genteel" and reserved. Many Hove residents are appalled by the Gehry plans, both the original and the scaled-down versions: the towers are totally out of keeping with the character of Hove; they are bounded on three sides by conservation areas which are as far removed from Gehry's "crumpled dresses" as you could imagine, and they will rise in front of, and restrict the beautiful sea-view of all the pre-existing buildings opposite the current two-storey development.

If Brighton and Hove Council wishes to have a "world-class development" of such breathtaking originality, far better to position it somewhere in Brighton, and leave Hove seafront alone.



Abominable devices for climate change

Sir: Whilst the main thrust of the climate damaging effects of air travel is correct ("The real cost of air travel", 28 May), some details are flawed. What kind of plane is a DC 747? Do you really think that a Mini can go 640 times round the earth on 1,196 kg of fuel (equivalent by my calculation to 15 thousand km per litre)?

However, your concern for climate change is hugely weakened by the banner headline above the article that draws our attention to "the 50 best garden essentials", which includes a 11.5 kW patio heater. These devices are abominations specifically designed to change the climate. Instead of pumping the equivalent of 11 bars of an electric fire into the atmosphere, why not put on a pullover or go inside?



A vote reform we could achieve

Sir: Congratulations on making electoral reform an important issue. I would prefer the single transferable vote, but that is unrealistic. The Labour government would never adopt an electoral system under which they would suffer so badly. But I remind you of the Jenkins report. This suggested a hybrid electoral system, AV-plus, and Blair would do well to take another look at it.

The MP-constituency link that so many supporters of first-past-the -post view as essential would be maintained, yet there would be a strong proportional element with the top-up. In many ways this is similar to the Additional Member System used in elections to the Welsh and Scottish devolved bodies.

This would create a much fairer, more accountable system. Lord Jenkins did a good job with the report, though it was ignored by Blair. Why now make another commission into electoral reform? Implementation of the Jenkins report is long overdue.



Sir: I must take issue with Roy Bradley's assertion that PR in Scotland has been a "disaster" (letter, 31 May) and that list MSPs have no responsibilities.

A couple of years ago I wrote to both my councillor (on 45 per cent of the vote, 90 per cent of Glasgow councillors are Labour) and later the list MSP whom I had actually voted for. The MSP made a thorough investigation of my complaint. I have yet to receive a reply from the councillor. I do not believe that I am alone in preferring to be represented by someone I voted for rather than someone to whom I may be geographically linked.

Were Scotland still to have first-past-the-post Labour would, on 39.5 per cent of the vote, get roughly 80 per cent of the seats. I do not claim our government as a shining beacon (though the debacle of the Parliament building was created by Westminster who handed it to us and ran away) but there is no general clamour for a return to that system.



Sir: Parliament was influenced in its decision to support the first Reform Act of 1832 by more than serious rioting in Bristol, as Andreas Whittam Smith mentions (Opinion, 30 May). In July 1830, the citizens of Paris revolted against an attempt by Charles X, the last Bourbon King of France, to reverse the gains made by the French Revolution, and to reinstate absolute monarchy. On that occasion, unlike 1792, the King did not lose his head - merely his throne.

With this in mind, the landed interests in both Houses of Parliament decided that it would be better to run the risk of losing seats than to lose heads.



Sporting refunds

Sir: The spectators at Saturday's Test between England and Bangladesh were entitled to a refund due to the match ending so quickly. Shouldn't the Milan supporters at last Wednesday's Champions' League Final have been offered some similar recompense, as the game was too long?



Sense of proportion

Sir: Patricia Craig writes that "the horrors of Long Kesh prison in Northern Ireland belong in the catalogue of 20th-century enormities" (Books, 27 May). Hitler, Stalin and Mao Zedong killed millions in the course of the last century; millions more died in Rwanda; thousands were killed by the junta in Argentina. At the Maze Prison (as Long Kesh is properly known) ten men deliberately starved themselves to death in 1981.



Political weather

Sir: Andrew Grice (The Week in Politics, 28 May) writes that Tony Blair has been greatly influenced by Lord Jenkins' dictum, "Great prime ministers change the weather." Finally, the true explanation for the new, much maligned television weather maps.



Encounter on the bridge

Sir: Going for a midnight walk recently I found myself alone on the Millennium Bridge admiring the view to the west. After some time I suddenly became aware that my solitude was broken. Turning, I noticed a fox had joined me half way across the bridge from the direction of Tate Modern to the south. It was wonderful to see the creature that now accompanied me and was sharing the tranquillity of the night and the bridge with me. I was truly thankful that Otis Ferry and his lurchers weren't approaching from the north.



Springer's warning

Sir: Jerry Springer's accusation that British television lags 10 years behind its US counterpart is certainly disturbing. At least 20 or 30 would be preferable.