It should come as no surprise that the inquiry into maternal and neonatal deaths at the Shrewsbury and Telford Hospital Trust (“Inquiry demands NHS overhaul to prevent baby deaths”, 10 December) should find that the underlying issue was an institutional belief in “natural” vaginal birth in a standalone unit.
In any situation – medical, educational, political and obviously religious – where humans form units of like-mindedness, a culture of dogma over evidence can, and painfully often does, prevail.
Discussions about health matters should depend on clients being able to trust that the professionals with whom they consult are free of pre-existing belief systems that allow prejudice to come before evidence, and bias to obscure judgement and rational assessment. That this was not the case at the Shrewsbury and Telford Hospital Trust is manifestly a deep regret, but equally should not be an unexpected finding.
Low caesarian section (CS) rates are not a sign of good maternity care. The idea that vaginal delivery is superior to CS has been abandoned by the World Health Organisation (WHO), which does not recommend an ideal CS rate. Since 2015, WHO policy has been that, “every effort should be made to provide caesarean sections to women in need, rather than striving to achieve a specific rate”.
There is no empirical evidence for an optimum rate of CS. Some of the increase in CS rates is attributable to women’s choice – a welcome manifestation of female empowerment.
Individual care, not artificial targets, should be the aim in pregnancy.
Dr John Doherty
Bluster blows the house down
More than 20 years ago, Boris Johnson was telling lies and half truths about the EU. His ignominious career has continued this familiar pattern with writing on buses and misleading spin on the Northern Island protocol, to name but two examples.
We should not be surprised therefore that he has to continue to lie – once a liar, always a liar. In the present impasse it should also be no surprise that the EU is not prepared to trust Britain under his leadership.
Let’s hope it will not be a full four years before the electorate is given the opportunity to show their distrust also.
I can’t have been the only one who looked at the photo of David Frost and Boris Johnson alongside those elegant, well dressed Europeans and wondered why Johnson couldn’t afford a better-fitting suit. Then I was reminded that he’s struggling on a £150,000 annual salary. That’s not all he’s struggling on but, that apart, perhaps he should consider asking his dad for a loan. Lots of kids do these days.
According to Johnson, the odds of no deal have changed from a million to one to highly likely. Did he forget to turn the oven on ?
Make rugby safer
Reading Katherine Merchant’s article on concussion in rugby (“Concussions forced me to quit professional rugby – now I’m worried about my future”, 9 December), I was reminded of what we were taught when I first started playing as a youngster. So much of what we learnt was focused on keeping your head out of the tackle and other pressured areas.
The game is obviously much changed today, decades on. But it was my pleasure to find myself on a train with a senior member of the RFU before the pandemic. We had a really good talk about all things rugby. Concussion came up and I was interested to hear that research was not pointing to tackling or pressure in scrums as the biggest problem area. But instead “jackeling” and “pick and go” as the consistently dangerous areas.
A combination of the sheer size of all players and the impact of collisions in attack and defensive, with heads inevitably in the lead at the points of impact, was proving the danger.
So change will need to address these impacts. Addressing size and weight, the need to get the head protected while jackeling and reduction of those crunching impacts at pick and go around the ruck seem to be logical areas for attention.
But a return to keeping your head out of danger seems critical, too.
Drug policy has failed
I find myself agreeing wholeheartedly with Ian Hamilton’s assertion that illicit drugs policy be reviewed (“Laughing gas is now almost as popular as cannabis – but drug use isn’t the real proble”’, 9 December). It currently does little to prevent the flow of drugs into Britain, there is little or no help for users and after 50 years, users are still causing untold misery in their communities.
But where I would take issue with him is that using, selling and importation of illicit drugs has wreaked havoc in every country that has failed to prevent the spread of drug use. To say that “drug use doesn’t cause too many problems for individuals” is misleading. It’s not the user that suffers from drug use but the families and communities plagued with shoplifting, house breaking, theft, rival providers violence, etc.
The “main threat” to society is still illicit drug use; however, our drug policies do little to assist users to rehabilitate or safeguard users’ health. Instead, our drug policies make those dependent on drugs social outcasts and criminalise them.
Unless there is a comprehensive review of our failed policies of the past 50 or more years, we will still be bewailing the plight of our communities where rampant drugs use has wrought so much pain.
A new policy must include youth education, practical and financial support, free drug supply and stop criminalisation of users. If the government (via NHS) took control, users would be less inclined to steal and be antisocial. Users’ family lives would be less chaotic and communities safer from theft.
Cannabis and nitrous oxide seem to me to be “gateway drugs”, which could lead users to experiment with other, more harmful illicit drugs. We ought educate our young people that following a dangerous, ruinous path is avoidable.
There has been a lot of talk by many, including Christopher Nolan and your own Charlotte Cripps (“Christopher Nolan is right – big films need big screens”, 11 December), about the possible demise of big screen cinema.
I say that the cinema chains have for so long discriminated against a significant minority of the population that they deserve everything they get. This discrimination, by limiting sub-titled screenings to occasional and unsociable hours, ensures that anyone with less than perfect hearing is wasting their time going. The streaming alternative always (or almost always) has a sub-title or closed captioning option, which ensures that every viewer, whatever their hearing ability, is catered for.
Until cinemas offer all or practically all screenings with sub-titles, it will remain an avenue of pleasure which is permanently closed.
Havant , Hampshire
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