Simon Jenkins takes aim at the wrong targets when decrying the problems facing the NHS (Here’s what my fantasy Labour party would look like, Opinion, 15 January). It is not GPs or hospital doctors who are holding back the NHS; their hard work means patients continue to receive high-quality care, including emergency care around the clock. Doctors want to do more, but they can do that only if they are given the resources, facilities and staff to do so. For example, a recent British Medical Association survey showed that seven out of 10 GPs felt their facilities were too small to provide extra services, even though GPs want to do more for their patients.
We also need to ensure that the resources we do have are used appropriately: is there really a widespread demand, as Simon Jenkins suggests, for routine GP appointments at 3am? Would the money not be better spent having more healthcare staff available in a range of disciplines in better facilities when patients are more likely to use them? Moreover, calling for people to declare their income when they need to see a GP or have an operation so they can pay means-tested charges would destroy the social solidarity the NHS is based on. There is little doubt that the NHS is under unsustainable pressure and, in a general election year, we need a serious debate, underpinned by the need for healthcare to be free at the point of use, about how we meet the challenges we are facing. Doctors want to be part of these solutions.
Dr Mark Porter
Chair of the British Medical Association’s council
• Your article (Running out of road: exhausted paramedics pick up the pieces of broken health system, 14 January) highlights the pressures on this service. But I wonder if readers realise just how appalling paramedics’ general working conditions are out of the crisis spotlight? As a counsellor I see paramedics when they become too stressed or are traumatised. There are no other professional groups I see who seem to me to be so grossly underpaid and who tolerate such inhumane working conditions, given the level of trauma they deal with. It is not uncommon for them to be spending their long shifts alone, responding to emergency after emergency with no downtime, no time back at the hospital to unload emotionally. We seem to treat them with no respect and as highly disposable objects. The plight of professional groups such as the paramedics is not about lack of funds – there are plenty of people who are paid a fortune by the NHS. It is rather, as always, that the professional power groups get the biggest slices of the cake.
One last thing. There is a solution to ambulances queueing up at A&E. Although ministers keep exclaiming that there is no more money for the greedy NHS, all over the service money is being lobbed at dead-end projects, new IT packages that will not work and expensive management consultants. But, of course, those are different budgets.
Suzanne McCall
Luton
• In 2010 my son-in-law gave up work to do four years’ paramedic training. During the first year the government announced there would be no further recruitment of ambulance technicians (a job he needed while undertaking the three-year paramedic degree). As he successfully completed his access year, the government then announced that the NHS would no longer finance the three-year paramedic degree course – requiring him to pay £9,000 a year like other degree courses. Unable to face a debt of £27,000, my son-in-law found alternative work and, lost to the NHS, he uses his skills as a volunteer with RNLI.
Christine Guedalla
London
• Lord Ashcroft is wrong to perpetuate the myth that lack of explanation lies behind wide rejection of the Lansley reforms (The Tories are still toxic on the NHS, Opinion, 14 January). They were only too well understood. We all know that high standards and cost-effectiveness are not evenly spread. We know, too, that bureaucratic tendencies and inefficient practices are found where there is inadequate management, in private as well as public organisations. Evidence is not adduced that profit-seeking firms are more beneficial to the service.
The government’s proper role is to set the overall structure, the parameters and the funding limits, within which the NHS is accountable. Excellence in leadership, effectiveness and efficiency must be demanded, along with continuous review and development. Cynically shrugging off responsibility to arms-length operators driven by profit is not acceptable in an agenda for “modernisation”.
Lord Ashcroft is right about one thing: we need a proper conversation about all of this.
Howard Layfield
Newcastle upon Tyne
• Sarah Boseley (More money is certainly needed – but that’s not all, 14 January) and your front-page report miss the core problem that compared with other western countries we get our NHS on the cheap.
Based on US Bureau of Statistics data, research shows that in 2008, the latest date for which we have data, we are 17th out of 21 countries. Worse, over the past 20 years, our average was 20th.
Greece and Portugal, which used to have higher child mortality rates than Britain, spend 9.5% and 10.2% of their national wealth on health to the UK’s 8.7%, and now have substantially lower child deaths rate than Britain. When recognised in this way, the solution becomes obvious: that the UK should match the average health spending of other western countries.
Colin Pritchard
Research professor in psychiatric social work, Bournemouth University, and emeritus and visiting professor, department of psychiatry, University of Southampton
• The decision by NHS England to de-list a number of drugs from the Cancer Drugs Fund for use in treating blood cancers is worrying (Boost for cancer fund as drugs list pruned, 13 January). Patients with many types of leukaemia, lymphoma and myeloma can now live for many years with a good quality of life, thanks to the development of new drugs. While not all types of blood cancer are curable, decades of research have led to incremental increases in survival times that could eventually lead to cures. It is a mistake to dismiss the importance of any drug that can give precious extra months or years to patients and can prevent considerable suffering.
If we are serious about beating blood cancers and other forms of cancer, the government, NHS, charities and pharmaceutical companies need collectively to find a sustainable way to make these and the next generations of effective drugs available to patients who need them.
Professor Chris Bunce
Research director, Leukaemia & Lymphoma Research
