Letters: Shining a light on outsourcing in the NHS

These letters appear in the print edition of The Independent, 31 July, 2013

Dan Kantorowich (Letters, 19 July) writes of how his local hospital had the central heating on at full blast during this heatwave, and how nobody seemed to know what to do about it. Any of us who have had dealings with hospitals in recent years know that such things are all too common.

Everything is delegated, and outsourced to private contractors who choose the hours that they want to work. Something as seemingly trivial as the bulb in the anglepoise lamp above my father’s bed caused quite absurd difficulties.

It failed one Friday evening. The hospital were unable to do anything about it till Monday because that was when “maintenance” reopened. None of the nurses seemed to have access to a light bulb, or alternatively did but considered it too dangerous to change one themselves, or alternatively considered it beneath their medical expertise to perform such a task. It was left to us to get a replacement bulb and fit it so he could continue to read over the weekend evenings.

The National Health Service should make it a condition of any outsourcing that the companies given such contracts maintain a 24/7 presence at each hospital they cover. Maintenance, cleaning and such activities are not optional extras for our Health Service to be carried out at the convenience of huge private corporations.

Ian Craine, London N15

Given the growing body of evidence linking poor Registered Nurse staffing to mortality and other adverse outcomes, it would be interesting to see a graph showing average Registered Nurse-to-patient ratios for the 14 trusts alongside Professor Jarman’s graph of excess mortality (Andreas Whittam Smith, 17 July). I would anticipate considerable correlation. Unfortunately, as far as I know, this data is not publicly available. If the 14 trusts being investigated began by bringing RN numbers up to safe standards using an evidence-based methodology perhaps the “hit squads” would not be necessary.

Jennifer Hunt, Cambridge

You report (26 July) that, according to a survey, 51 per cent of GPs are in favour of charging patients to see them. This is a misleading statistic: 51 per cent, not of all GPs, but of the sample of 440, expressed this opinion. As in all surveys of this kind, the sample statistic is taken as an estimate of that among all GPs. Unfortunately, for technical reasons the sampling distribution of the proportion is not known. It approximates to the normal distribution if the sample is large, but 440 does not qualify, in my opinion. May I suggest that in future reports of this kind you provide such statistics with appropriate confidence intervals, so that readers can make better-informed judgements.

David Kaye, Corbridge, Northumberland

Pickles’ parking plan: problems

I have just heard on BBC news that Eric Pickles has suggested that parking on double yellow lines be allowed for 15 minutes, to encourage the use of local stores. I chair a committee, set up by my town council, trying to think up ways of removing congestion from, and improving traffic flow in, the centre of our small country town. One car parking on double yellows for even a couple of minutes can bring traffic to a standstill. The thought of allowing cars to stop for up to 15 minutes would bring absolute gridlock here. The idea is barmy and frankly shows how out of touch with reality so many of our urbanite parliamentary masters are.

Alan Lewendon, Fordingbridge, Hampshire

Not in their back yard. Or theirs...

It was no surprise to read Lord Young’s warning to the Prime Minister (“Localism hands power to Nimbys”, 27 July) that trying to push more decision-making to the most local level might worsen Britain’s housing problem. It is only common sense that giving more power over planning matters to local people will tend to stifle development: nobody is going to vote for new development on the field next door. Suggest the next county instead and you may get a few votes. The unwillingness of successive Governments to face down the Nimbys has contributed to the sluggish pace of house-building, the over-valuation of private housing and the imbalance between investment in housing and industry compared to our European competitors.

C Sladen, Woodstock, Oxfordshire

Royal misgivings

Reading “The Big Questions” (27 July), I wondered whether a page from the Daily Telegraph had been included in my copy by mistake. Alison Weir states: “the succession is assured now, and in good hands” and later on: “The abdication of... Edward VIII... is a precedent no British monarch would wish to emulate.” But the possibility of abdication in favour of the next in line should not be ruled out; otherwise we have the prospect of three kings, each succeeding at the age of 70 years old. So far, The Independent has done a good job of detaching itself from the hysteria on TV and in the rest of the press; but now it should examine such questions dispassionately, and not rely on the opinions of professional royal watchers.

John Dakin, Dunstable, Bedfordshire

Balancing spirituality and politics

I gather that usury is no longer a sin, provided the interest rates are lower than most payday lenders. Investment is a commercial necessity, but has to be with fairly ethical companies which do not sell too many arms. Your financial advisers obviously find it very complex to sort the good guys from the bad. Entry fees and shops in church buildings are also acceptable ways of making money, though I remember reading that Jesus got a bit cross about that sort of thing. Homosexuality, I think, has been grudgingly accepted as no longer sinful, though of course you won’t let gays get married in C of E churches or practising gays serve as bishops. Could the Archbishop of Canterbury please clarify for me?

Chris Wright, Madeley, Cheshire

If Jesus didn’t “keep to matters spiritual” as you put it, why should the Church?

In one of his summaries of what it meant to be a citizen of what he called the Kingdom of God (note, not the Church equivalent of his day with which he had a tempestuous relationship but something far more wide-ranging), Jesus calls for the feeding of the hungry, giving drink to the thirsty, welcoming the stranger, clothing the naked, caring for the sick and having a concern for those in prison (Matthew 25:35). How do you do that without being “political” and getting involved in the nitty-gritty of business, social and financial life?

Canon Tony Chesterman, Lesbury, Northumberland

All decisions in life are both “political” and yet simultaneously “spiritual”. They meld the material with a higher element. This might be defined as the Common Good or at a more metaphysical level, a reference to what Jesus might have done in such a situation. So we cannot dismiss so lightly the input of church leaders. To miss either the “political” or the “spiritual” from our decisions makes the end result unbalanced. Finally, to state that “such matters are a private affair”, is to close down valuable input.

Tom Baxter, Stratford-on-Avon

You make a mistake, I think, in assuming that there is a simple dividing line between things spiritual and those which are not. Surely causing people to unnecessarily enter into debt has significant spiritual consequences? Remember that Jesus was seen as being a political activist during his lifetime. There is very little which is not in some way spiritual.

Ian K Watson, Carlisle

Why the shock about the Church of England investment in Wonga? I remember years ago on The Mark Thomas Show how Channel 4 exposed the hypocrisy of the Church of England for investing in nuclear cruise missiles.

P Cresswell, County Fermanagh

Esperanto and Shatner

In your report about the campaign to secure international recognition for Esperanto (26 July), it was stated that William Shatner “starred in a science fiction film called Incubus in 2003, which was made entirely in Esperanto”. The film was actually made a whopping 37 years earlier, back in 1966. It also belongs to the horror genre, as opposed to science fiction – its plot revolves around succubi who lure victims to their death and offer their souls to the God of Darkness.

Martyn P Jackson, Cramlington, Northumberland

William Shatner did indeed star in a film called Incubus made in Esperanto, but not in 2003. The film was made in 1966 and, as it was released just weeks after Star Trek started on US television, I would guess he made it before starting work on that show.

Paul Dormer, Guildford

In defence of HRH

When will republicans such as Julian Gardiner (Letters, 25 July) recognise the peculiar advantage of an unelected head of state is that no one has voted against her and she doesn’t have an “agenda”? She just happens to be there and, in that way, is more like an ordinary person than someone who has led a successful campaign. Of course this only works so long as she is a gentlewoman in character. And it would be nice if they could show a little justice and divest themselves of some of their enormous wealth – but you can’t have everything in this life.

Antony Black, Dundee

Cull the gulls

I would much rather listen to the chirping of Daniel Emlyn-Jones’s African field crickets when sitting in my garden (letter, 26 July) than the usual sound of summer here in Bath – the deafening screeching and squawking of hundreds of urban gulls, all day and night.

Apparently they are a protected species, so no action can be taken against them, even though a cull is needed to reduce their rapidly increasing numbers.

Pete Dorey, Bath