What an excellent, graphic description (Feet first, our NHS is limping towards privatisation, 16 August) of what is happening to a greater or lesser extent throughout the NHS and particularly where surgical intervention is required. In many surgical units now, there appear to be only two categories of cases, “routine” and “emergency”. “Emergency” equals “death looming” or cancer. Everything else is labelled “routine” and may wait many months.
In Bristol recently, a 26-year-old with an operable cerebral tumour that was demonstrably growing and requiring surgery, was placed on a 12-month waiting list. The family had to raise over £27,000 for the operation to be done within a clinically appropriate timeframe. While the patient is vulnerable and clinically ignorant and consultants are gagged and disincentivised, what is clinically unacceptable in terms of suffering, morbidity and probably mortality remains largely under the radar.
Dr Helen Zeitlin
Bradford-on-Avon, Wiltshire
• Polly Toynbee’s article reflects the chronic state of NHS underfunding by successive governments. Margaret Thatcher rightly said “we can only have the services we can afford” but we have never afforded as much as most of the other western countries. Tony Blair wanted the UK to match the western European average of spending by proportion of GDP, and under Gordon Brown we spent 9.4% in 2010, the highest ever, but this fell to 9.1% under Cameron in 2011 and 2013. This is in stark contrast to the US at 17.1%, less than France at 11.6% and less than the financially prudent Germans at 11.3%. Currently the UK is 18th of 21 of the world’s richest countries, but between 1980 and 2013 our average of 6.9% of GDP is the lowest of all countries.
Professor Colin Pritchard
Bournemouth University
• Polly Toynbee rightly highlights the consequences of flying 15-minute care visits. Our research shows 18 councils are still commissioning these undignified visits, against government advice, to carry out essential tasks such as washing, dressing and eating. National guidance advises that care visits of at least 30 minutes are needed to help keep people well. Any shorter and it is impossible for carers to support each person with the basics like going to the toilet or making a cup of tea, let alone any additional medical health checks. With funding pressures increasing, this situation is only set to get worse.
Vital care including podiatry which can prevent hospital admissions has become a casualty in this current home care crisis. After more than three years campaigning on this issue, we know there is still a long way to go to end this lottery of unacceptable, undignified care.
Rosemarie Pardington
Acting chief executive, Leonard Cheshire Disability
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