Letters: We must be proactive in our quest for better health

These letters appear in the 24 October issue of The Independent

Sickness absence ruins working lives and brings great costs for the economy, so calls for employers to incentivise healthier lifestyles are welcome (News, 23 October).

Inactivity is wreaking havoc with the nation’s health and since many of us spend the bulk of our week at work – often sedentary – it makes sense for employers to take the lead.

This preventative approach – combined with fast access to health professionals such as physiotherapists for those who need it – is essential if we are to tackle the obesity crisis and reduce the ever-growing demand on the NHS. Some employers may baulk at the cost of such interventions but actually the Work Foundation found that for every £1 spent, £3 was returned through reduced absence and improved productivity.

They also yield broader savings for society by keeping people in work and reducing their need for benefits. The measures proposed yesterday by Simon Stevens – along Public Health England’s “Everybody Active, Every Day” framework – are therefore good news for individuals, employers and the economy as a whole. They must now be followed up with action.

Prof Karen Middleton

Chief Executive, Chartered Society of Physiotherapy, London

Reading about the future plans of NHS England leaves me deeply concerned. While the focus of the report on meaningfully addressing the root causes of ill health – and the need for radical upgrades and financial support for prevention and evidence-based public health interventions – is to be admired, the defence of the infrastructures of the market and privatisation are deeply problematic.

What is worrying is the broad acceptance of the ethic of privatisation, with its emphasis on personalisation, local flexibility in rules and regulatory requirements and a focus on efficiencies.

The issues of infrastructure and organisation in the NHS are about funding. Breaking down boundaries between doctors and hospitals, and between physical and mental health, may in some contexts be useful but they are not the key issues. This plays into the idea that “the NHS is unfundable and needs to change” – where there appears to be no alternative.

There are alternatives beyond the politics of tinkering embraced by the three main parties. The key issues facing the NHS are constant, chronic underfunding compared to other developed countries, wasteful internal markets, bankrupting PFI deals, the damaging physical and mental health impacts of austerity economics, and a failure to understand the way other core economic issues impact on the funding available for the NHS.

We spend at least £5bn annually on an internal market that does not improve patient care. We have just seen an unnecessary and damaging £3bn top-down reorganisation of the NHS. The answer to the health of our nation is manifestly not efficiency savings and the use of the private sector.

Dr Carl Walker

National Health Action Party, Brighton

It is clear that the results of smoking and obesity are the same: early death or expensive, avoidable stress on the NHS. While cigarette advertising is now illegal, it is incongruous that fast-food outlets can tart up façades of their premises with mouth-watering pictures of meals designed to stimulate the cephalic stage of digestion.

Vincent Knight

Cardiff

I wholly concur with Jane Merrick’s disdain for NHS England’s plan to pay GPs £55 for every patient they diagnose with dementia. (23 October 2014). What is the rationale? My only inkling has come from Jane’s own trepidation. We know that the continual increase in demand for GP services is due, in part, to the care required by the growing elderly segment of the population.

What if this is a cunning plot to curb this demand? Who, over say 60, will want to visit their GP, with whatever ailment, if there is a risk that they will be declared “demented”? We (I am, I admit, over 60) all know the care awaiting us in that eventuality!

Gordon Watt

Reading

If I were a GP I should be outraged at the suggestion that I needed a financial incentive to diagnose dementia. As a patient I might fear that an unwanted diagnosis might be about to be thrust upon me. As a taxpayer I’m (almost) speechless at yet more mis-spending of my money, possibly for a political purpose.

Susan Alexander

South Gloucestershire

It’s obvious what the Woolf test should be

Surely the test for the suitability of Fiona Woolf to chair the latest inquiry is very obvious. What would a judge do if a jury member, and foreman, disclosed the same level of acquaintance with the defendant in a trial? Unless the same policy is applied then the appointment is simply a case of an elite declining to abide by the same rules as it sets for everyone else.

I do not know the policy for juries but do know that if a member of a planning committee had the same degree of acquaintance with an applicant as in the parties in the Woolf case then, under rules laid down by the Government, they could face censure if they did not declare it and remove themselves from the discussion. The appearance of impartiality is important.

It is also debatable, especially in an era where official files can go missing, whether office staff for the inquiry should be drawn from the department being investigated. They may worry that their colleagues might not welcome them back, and give them an honour, if they did not soften criticisms.

John Kennett

Hampshire

In a nation of nearly 60 million people it should not be that difficult to find at least one person who is perfectly well qualified to head an inquiry into child abuse – and who does not believe that being Lord Mayor of London is not part of the “Establishment”. Oh, and does not live in the same street as Leon Brittan, but does live on the planet!

This chain of events would be laughed at as too unbelievably nonsensical to be included in even the most satirical of anti-establishment shows. As for the “victim community mind” comment – it says it all about the establishment community mindset.

Tom Simpson

Bristol

What’s so great about having 14 children?

I was shopping in a supermarket yesterday when I heard a man boasting that “he” had just had his 14th child. He obviously thought it was a magnificent achievement, with no thought for the cost to his country (us) of looking after all these children for him, nor the fact that he is contributing to the over-population of our country and our planet.

I am becoming more convinced that we should offer child benefit only for the first two children in a family (and nothing to those above a certain income) and that any more than two should be paid for entirely by the parents.

Gillian Smith

West Sussex

Looking after those on benefits

The report by major charities (23 October) into people with long-term debilitating conditions shows how much time and money is wasted trying to find people fit for work, who subsequently are found not to be fit after all, at a great financial and emotional cost. I have been working on benefits appeals for 17 years and have helped thousands overturn incorrect decisions and in most cases secure other benefit entitlements. The real shame is that many go without their correct entitlement because the Government uses the media to discourage benefits claiming, even by the most vulnerable.

Gary Martin

Benefits Adviser East London

Why Ched Evans must show true remorse

If Ched Evans believes he is innocent he has every right to appeal against his conviction, but whether his appeal is successful or not he must demonstrate true remorse if he is to resume his football career. A successful appeal would only show that he might not have acted illegally.

His responsibility is wider than merely not acting illegally. His actions, whether legal or not, have brought shame to a great football team and to the reputation of all professional football players. If he wants to be rehabilitated into the football world he must apologise wholeheartedly and give unreserved assurance that he will avoid the risk of any repetition.

In common with all who benefit from their position of being role models he shares the duty of being better than merely law abiding.

Clive Georgeson

South London

A calypso that brings back memories

Matthew Norman’s piece in today’s paper made me think of my wartime service in Trinidad. There was one calypso I would like to repeat for your enlightenment.

When the Yankees came to Trinidad They got the young girls going mad.

Young girls say they treat-em nice,

Make Trinidad like paradise.

Drinking rum and Coca-Cola Go down point Tumana

Both mother and daughter, Working for the Yankee dollaaaar!

John Scase

Exeter