Will Hutton’s excellent piece “Doctors, teachers, the police: our public servants are demoralised” (Comment) encapsulates so well the grinding impact of 30 years of public service “reform” on professional morale. A further question then arises as to the financial case for what has happened. Part of the justification for passing more resources and power to the private sector was that it would be more cost-effective than management by public service bureaucracies. Comparisons of accountancy, legal and other contract management costs with alternative public sector methods are hard to find. It isn’t easy, though, to see how it could be done, with many former public servants now in the private sector and their functions managed by companies; a job for academe?
Public service systems had many shortcomings that could have been addressed specifically but the assumption was that schemes such as the private finance initiative (PFI) were “the only games in town”. The advantage of a mixed economy is that choices on how to provide public services should be based on what will best serve the public rather than assumptions based on dogma. Too simple perhaps.
Andrew Seber
Winchester
My son is a junior doctor and his wife a trainee GP and if they felt strongly enough to spend one of their rare weekends off trying to make their voices heard, I feel it is time their senior colleagues stood up to support them (“‘We have no other way to stop this’: junior doctors to hold strike ballot”, News).
I have been a GP for 32 years and our last new imposed contract, transferring funding to clinical commissioning groups, was supposed to be “a good deal for doctors”. What we have seen is five years of pay cuts and constant cutbacks and pressure not to admit patients to hospital or refer them for the care they need. Due to an unsustainable workload and lack of resources to employ the number of GPs we need, I have taken the difficult decision to retire next year.
Sadly, I feel immeasurable qualities such as experience and continuity of care are no longer valued. I fully accept that the NHS cannot continue in its present form. What the public needs to be made aware of is that this government is cynically forcing the privatisation of the NHS. Hospital trusts and GP surgeries will be unable to provide the services the politicians promise and will be either forced to privatise or collapse. It will then be presented as the doctors’ fault. Who do patients believe – their doctors or the politicians?
Dr Nigel Butler
Ongar
Essex
Not only are teachers demoralised but the DfE’s boasts about rising educational standards are empty.
Last month, Dr Paul Cappon published Preparing English Young People for Work and Life: an International Perspective. He is an expert on comparative education whom the DfE appointed last year to evaluate its present policies. His report makes uncomfortable reading for the department. He notes that despite many years of high-profile central government initiatives to improve our educational performance, our unimpressive position in international league tables has barely changed and we are the only country within the OECD whose young adults have literacy levels lower than older generations. He argues that there is no evidence that our stringent, Ofsted-led accountability system lifts national standards; further, that central government mistakenly tries to remedy everything on its own, ignoring local communities and families.
Teachers’ morale would be improved substantially if the DfE introduced a new approach to accountability that prioritised school and local self-evaluation with Ofsted in a diminished monitoring role. Teachers will flourish and their pupils benefit.
Martin Roberts
Former head teacher, the Cherwell School
Oxford
