As doctors in England, we are writing to express our conviction that the Health and Social Care Bill will irreparably undermine the most important and admirable principles of the National Health Service, and to appeal for its rejection by the House of Lords.
Because it is universal and comprehensive, and publicly accountable, and because clinical decisions are made without regard for financial gain, the NHS is rightly regarded all over the world as the benchmark for fairness and equality in healthcare provision.
The transfer of services to private, profit-making companies will result in a loss of public accountability and a damaging focus instead on low-risk areas that are financially profitable. A confused patchwork of competing providers will deliver a fragmented and inequitable service, and any reliance on personal health budgets or insurance policies will increase inequality.
Because there will be a financial incentive for providing treatment, patients will be over-treated, the potential costs of which are limitless. The possibility of the commissioning role being outsourced to the private sector is also of deep concern.
In forcing through this ill-conceived Bill, without an electoral mandate and against the objections of healthcare professionals, the Government is also ignoring overwhelming evidence that healthcare markets are inefficient and expensive to administer.
The public has been misled by claims that no major reorganisation of the NHS would be undertaken, by repeated denials that what is happening represents privatisation, and by suggestions that the Bill enjoys the support of the medical profession. We do not accept that "things have already gone too far". The enactment of some of the Bill's proposals has been premature and possibly unlawful, but some of its most damaging aspects may still be mitigated. We believe that on moral, clinical and economic grounds, the Health and Social Care Bill must be rejected.
Dr Jonathan Folb
Consultant Microbiologist, Liverpool
Dr Clive Peedell
Co-Chair NHS Consultants' Association and Member of BMA Council and Political Board, Consultant Clinical Oncologist, Middlesbrough
And more than 1,000 others. Click here to see the full list of signatories.
The many distinguished signatories to your letter on the NHS Bill ("No one voted for the NHS to be privatised", 10 October) are absolutely right. No one voted for NHS privatisation, and no one will be voting for it in the future, because that is not what the Bill before the House of Lords is about.
We will never "privatise" the NHS, will never pursue competition as an end in itself, or on the basis of price. This Government is absolutely committed to maintaining Nye Bevan's vision of the health service, free to all, on the basis of need.
But the question is, how the NHS can continue to improve against a backdrop of extremely constrained public finances, with an ageing population and rising costs?
Giving patients the ability to make real choices about their treatment, and frontline staff the ability to take control of the services they can offer, are at the heart of solving this problem. We have already listened to thousands of voices as part of our listening exercise on NHS modernisation earlier this year.
We are committed to continuing to listen, but a point must come where the NHS has the legislation it needs to move forward and make progress for patients.
Simon Burns MP
Health Minister, House of Commons, London SW1
Child poverty is underestimated
In the Institute of Fiscal Studies report on child poverty report, 11 October), it uses the income before deducting housing costs when showing that the number of children in poverty in Britain will rise by 600,000 to 2.8 million by 2012-13, because British governments have always used that headline measure.
It seriously understates the depth of income poverty in an expensive economy. It is the income after deduction of housing costs which is the better measure; it has to pay for the rising prices of food, fuel, clothes, transport and debts, and the rent arrears when the capped housing benefit does not pay all the rent and the extortionate interest of payday and door-step lenders.
The IFS report also projects that the numbers of children in absolute poverty after deducting housing costs will be 3.8 million in 2013, up 1.3 million since 2008, the number of working age parents at 3.3 million, up 1.2 million, and working aged adults without children will be 4.8 million up 1.6 million.
The reality is even worse. The Centre for Research in Social Policy has shown that the weekly cost of a healthy diet, currently £46.31 a week, will soon overtake the £53.45 a week adult unemployment benefit for the under-25s.
There are no plans in the Welfare Reform Bill which will start to reverse the national disaster of a rise of over four million to nearly 12 million people in absolute poverty over the past five years, and that does not count the plight of pensioners.
Rev Paul Nicolson
Chair, Zaccheus 2000Trust,
Reaction to our redesign
Chris Blackhurst has made one of the most significant decisions in the newspaper's 25-year history, to rebrand The Independent as a dynamic, sharper, easier-to-access paper to compete with its rivals.
I must say that the previous Independent had a few flaws in its layout and design; I remember having problems reading the text and, as Blackhurst rightly points out, I usually left my Viewspaper at my office (as is the case with most pull-outs, hence The Guardian's recent move to integrate it into the main newspaper). The Independent should be given a pat on the back; it is fresher, easier to read, sharper, and more enjoyable.
It is like a mix between Times and Telegraph (my initial reaction). It was the first newspaper I noticed with its fabulous bold header and very readable text.
Walsall, West Midlands
Have you not heard the phrase, "If it ain't broke, don't fix it"? If I wanted a paper that shouted at me I wouldn't buy the Independent. We readers are intelligent enough not to need a paper that is "more readable". The fonts were already excellent and are now dumbed down.
As to the Viewspaper; it was the section that I reached for first in the morning while my husband started on the main section. I read the rest of the paper later and cannot now separate the part that I want to read first.
Having just come home from a lovely weekend in Paris, to celebrate our first wedding anniversary, at the age of 77 (so we are not allergic to change), it was a nasty shock to find my beloved newspaper so different.
I hope that I will get used to it but I'm not happy.
Well, losing the Viewspaper is still a "miss'"but the new fonts and "signposting" really are good. Much easier to read, and yes, overall, more accessible. Which I admit might to some small extent negate the ill-effects of losing a separate section ...
The abandonment of small grey print in the Sports section is welcomed by my partner, who simply couldn't read it (and probably also a lot of other people in their 60s and 70s couldn't either). It's still the only paper I want to read: so thanks and best wishes.
You are wrong to suggest that the Viewspaper was "taken out" to be either read later or discarded. Separating the Viewspaper was never easy and was done for a very good reason. One was to share the contents with a partner then to exchange for further reading.
Another was to conveniently separate out some of the important elements such as the Editorial, Letters to the Editor, TV and Radio, which incidentally are now very difficult to find in the new format. Deleting Viewspaper was a mistake.
We are not at all certain about the new layout. It feels messy, but at least it is news-heavy and waffle-thin. But why such a small Letters section? Did no one write to you yesterday? We'll see how the week progresses.
Martin and Mary Bates
Old enough to remember the war
Why does Adrian Hamilton state that Gerhard Richter "claims" to remember the Dresden bombing (Arts & Books, 10 October)? I was evacuated to a village in Essex and I was only six years old when the war ended, but I have vivid memories of it. Richter would have been 12 or 13 at the time, and it would be astonishing if he did not remember one of the most traumatic events anyone could be unfortunate enough to witness.
It's a talent
I have for many years enjoyed this newspaper's propensity for homonym homophone confusion. Particular favourites include the description of a notorious moneylender as a "lone shark", and the claim by a senior embattled industrialist that he was "in for the long hall". Yesterday's digital digest contained the phrase "waiting with baited breath". Keep it up; it's annoying but quite entertaining.
In these days of economic gloom, it amazes many joining the dole queue that London Underground drivers have been offered £50,000 a year for a 35-hour week, plus a bonus of £1,800 for working normally during the Olympics, doing their usual job. These drivers are now among the top earners in the country. So much for the Chancellor's austerity lesson.
Donald J MacLeod
Bridge of Don, Aberdeenshire
I'm intrigued at the correspondence about adopting the brace position (Letters, 11 October). I have tried to do this on every flight of late but have not been able to get beyond 45 degrees before my head meets the back of the seat in front.I would very much appreciate any advice on how to maximise my chances of survival in economy class.
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