Letters: Corruption and poverty to blame for scandals

Mary Wright (letters, 26 January) is right in asking about a lack of 24-hour GP care, but what Mary Dejevsky was really referring to (Comment, 15 January) was the sad, inevitable outcome of the new GP contract forced upon bewildered, overworked doctors in 2004.

The fault rests squarely with a government anxious to gain control over the delivery of primary healthcare, in the vain hope of providing the same level of care for less money. Under the old system, GPs had a 24/7 contract for patient care and took a professional pride in delivering high-quality care at all times.

Now this devious government has invented a new healthcare provision (Out of Hours), mis-named it as a GP service, which it is not, and engaged local PCTs to run it. As we have learnt, the doctors working for this service are not necessarily GPs. Dr Daniel Ubani, who accidentally killed a British patient with an overdose, is a German cosmetic surgeon.

The language Ms Dejevsky uses in her article ("GPs ... almost universal abandonment of working nights and weekends", "GPs have fled out-of-hours working", "foreign doctors ... flying in ... to work the hours British GPs had spurned") highlights the wide lack of understanding of the radical changes to the delivery of healthcare in this country.

Many GPs (myself included) still work for the Out-of-Hours service and take great pride in striving to provide an excellent service under very difficult conditions where our professional responsibilities are sometimes severely exposed.

During the recent holiday, there was a backlog of 300 calls to patients and a delay of four hours. These are the sort of working conditions that would tempt even the most committed of GPs to "flee the out-of-hours working"; our professionalism stops us.

Dr Nick Bell

Oxford

Briefly...

Haiti horror in focus

Andy Kershaw's article on Haiti (21 January) was one of the most informed since the earthquake. He is spot-on in his criticism of some western television. I watched open-mouthed at some of Matt Frei's alarmist reporting for the BBC. Yet most pictures show the Haitians dealing with their tragedy with incredible stoicism and dignity. Thanks for bringing this faux sensationalism to wide attention.

Nick Jennings

Tisbury, Wiltshire

There's no TV. Amen

Canon Simmons is not alone in receiving TV licence demands for a church (letters, 28 January). I regularly get them for a church-hall car-park. After eight years, I have come to the conclusion that there isn't a human being at the other end. We have told the TVLA repeatedly that this is an error, and the demands still come with increasing officiousness. So I now bin them. As for the prospect of an enforcement visit, I say bring it on. It will make interesting photos for Facebook.

Revd Canon Ian Black

Vicar of Whitkirk, Leeds

Slim patient, fat bills

Last February, I underwent weight-loss surgery and have shed almost 11 stone. There is overwhelming evidence that the best treatment for obesity long-term is surgery ("An ethical trap for the NHS", 22 January). PCTs say they face a dilemma with funding these operations. What they cannot seem to grasp is the potential cost of patients like me over the next 10 years when I would develop diabetes, joint problems, heart complications and cancer. How much am I going to cost then?

Daniel Brookbank

Pevensey Bay, East Sussex

All eyes on Essex

In the article on "Constable's lost location" (26 January), two references are made to the county of Suffolk, but the map shows that, of the four reference points, two are south of the river Stour, in the county of Essex, and one is the river itself. As a resident of north Essex, I suppose I should be relieved that the beauty of this part of Essex is such a well-guarded secret.

Cate Gunn

Colne Engaine, Essex

Come again, ET

"Is anybody out there?" you ask (article, 26 January). Could it be that alien scouts have already reconnoitered Planet Earth and assessed its mean-spirited inhabitants as not worthy of further contact?

Julien Evans

Chesham, Buckinghamshire

Echo of Nuremberg hangs over Chilcot

The question whether the invasion of Iraq in 2003 (report, 28 January) was legal or illegal is in danger of appearing esoteric. It is not. The "General Treaty for the Renunciation of War" of 1928 (the so-called Kellogg-Briand Pact), which remains in force, was used as an important legal base for the prosecution in Nuremberg of those held responsible for starting the Second World War.

In the Nuremberg judgment it was stated as follows:

"The question is, what was the legal effect of this pact? The nations who signed the pact or adhered to it unconditionally condemned recourse to war for the future as an instrument of policy, and expressly renounc-ed it. After the signing of the pact, any nation resorting to war as an instrument of national policy breaks the pact. In the opinion of the Tribunal, the solemn renunciation of war as an instrument of national policy necessarily involves the proposition that such a war is illegal in international law; and those who plan and wage such a war, with its inevitable and terrible consequences, are committing a crime in so doing.

"War for the solution of international controversies undertaken as an instrument of national policy certainly includes a war of aggression and such a war is therefore outlawed by the pact. As Mr Henry L Stimson, then Secretary of State of the United States said in 1932: 'War between nations was renounced by the signatories of the Kellogg-Briand Treaty. This means that it has become throughout practically the entire world ... an illegal thing. Hereafter, when engaged in armed conflict, either one or both of them must be termed violators of this general treaty law... We denounce them as law-breakers'."

A similar denunciation from the Chilcot inquiry would not be inappropriate.

Wade Mansell

Professor of International Law, University of Kent, Canterbury

Occasionally, even the unacceptably tame Chilcot inquiry adds another small fact to the increasing pile of evidence that demonstrates that neither the US nor the UK engaged with the UN in good faith. They were willing to use the UN for their aims, to find legitimacy for the war, but were never willing to accept its authority. The decision to go to war was made through private agreements, and the only concern by either government (more accurately, those in control of the governments) was to sell the case for the war. The die was cast long before the question of the second resolution came up.

Tony Blair had a harder time of selling the case for war to the British public than Bush to his country: Tony could not even trust his own cabinet. Ever increasingly, it appears that the sole preoccupation of those in his inner circle was how to get away with it.

Is there a single document anywhere that shows even the slightest concern or interest by any member of the inner circle in how the post-war society would be for the Iraqi civilians? The dissent was not crushed. It was simply ignored. Anyone who had not bought into the project fully was at best used, as was Lord Goldsmith, or ignored, as were Robin Cook and Clare Short.

Jari Junikka

London SE5

I realise it's heresy even to ask, but why on earth should we care about the legality – or otherwise – of the Iraq war? "Illegal" is not, after all, synonymous with "immoral" and international law is, to say the absolute minimum, a somewhat nebulous concept.

Isn't it obvious that putting legality ahead of morality leads, inexorably, to the toleration of evil regimes, to passivity in the face of massacres (Rwanda, Srebrenica, Darfur) and to Russia, China and France having the power to veto whatever they like?

Was leaving Saddam Hussein in power, while killing a million innocent Iraqis with the UN sanctions that thwarted his WMD ambitions, "moral" because it was legal? Would the ousting of this genocidal despot – by volunteer armies – now have to be condemned as "immoral" if it could be proved beyond doubt that Bush and Blair acted "illegally"?

KEITH GILMOUR

GLASGOW

Michael Savage reports (22 January) that Jack Straw "deeply regretted the grave loss of life" as a result of the invasion of Iraq, adding that "We did not have the benefit of hindsight". We can all perhaps recognise that particular sentiment but what we require from our Foreign Secretary and indeed our Prime Minister before they embark on any military adventure is a degree of foresight.

Both the chief UN weapons inspector at the time, Hans Blix, and a former weapons inspector, Scott Ritter, urged caution in the approach to the war. But they were ignored in a headlong rush to invade that country. Oh yes, hindsight can be a wonderful thing, but foresight is infinitely better.

Jeff Hebblewhite

Harrogate, North Yorkshire

Isn't it curious that Lord Goldsmith was never directly asked if he was pressured to change his mind over the legality of the Iraq invasion? Instead, he was given an easily deniable scenario from a tabloid newspaper involving two junior colleagues, Falconer and Morgan, "pinning him against a wall", and simply asked to comment. "Utter nonsense" it may well have been, but it did not address the matter of "pressure".

I trust he will be recalled to the inquiry to answer a more precise question.

BILL ANGUS

KENDAL, CUMBRIA

Anthony Scrivener QC says that the opinion expressed may depend on the facts of the case. Does this imply that there may be circumstances in which the facts of the case may be considered irrelevant in reaching "the opinion"?

William Moloney

Bishop's Stortford, Hertfordshire

Food for thought in our nurseries

We are concerned by the claims of the Organix/Soil Association's campaign "Better nursery food now" and its calls for "undercover mums" to visit nurseries (report, 20 January). You would find it very difficult to find any nursery managing to feed a child on 25p a meal. Nurseries help children stay happy and healthy, and must meet inspection requirements.

There is a danger that asking parents to be suspicious of nursery food will cause misconceptions. Much of the food is home-made with fresh ingredients, every part of the process designed to be as healthy as possible, but it is good for parents to have a frank discussion with a nursery about the food.

Some reports claim nursery food is "too healthy", with meals more appropriate to older children, and we agree that more support, guidance and training is needed so nurseries can deliver the best possible menus that meet a child's needs.

Purnima Tanuku

Chief Executive, National Day Nurseries Association, Huddersfield

Horse sense about homeopathy

The "homeopathy is placebo" argument is becoming interesting. Vet Emma Milne (letters, 27 January) suggests horses treated with homeopathy would have got better without intervention because their diseases are mostly self-limiting. It must surely follow that most horses treated with conventional drugs would also have got better without intervention. If so, perhaps the veterinary profession should be worried about this revelation.

As for the placebo effect on humans, my husband had a severe sinus infection and tried four different homeopathic remedies but none worked; where was the alleged placebo effect when he really needed it? In fact, only over-the-counter painkillers worked. Does this make homeopathy a placebo which doesn't work but paracetemol a placebo which does?

Professional, registered homeopaths study remedies, philosophy, ethics and medical science for four years and commit themselves to ongoing continuing professional development afterwards. Although they do not study for as long as vets and doctors, think how much shorter that training could be if they needed to know only about placebos.

Jane Hurley

Teignmouth, Devon

Emma Milne tries to explain how the placebo effect works on horses through "the high incidence of self-limiting disease", which factor applies whatever treatment is used, "and the statistical phenomenon of regression to the mean" (whatever that may mean).

Yet common sense tells us that there is a psychological effect on humans given a placebo; even with intelligent animals such as horses, there is not the same awareness, and therefore not much, if any, psychological effect.

If you give the wrong remedy in homeopathy, nothing happens. At least there are no side-effects as with orthodox medicine.

Dr Cynthia Holloway

Hove, East Sussex