As Polly Toynbee scathingly pinpointed in her splendid article (Jeremy Hunt saves his own skin as he lets the NHS sink, 26 July), the NHS is as dependent on injections of foreign labour as a drug user is on heroin. According to the OECD report Health Workforce Policies in OECD Countries, published in March, Britain is the world’s second largest importer of health workers after the US, with more than 48,000 doctors and 86,000 nurses in 2014. While 5% of Italy’s and 10% of Germany’s doctors were born overseas, the figure for the UK is a shameful 36%. Shameful because in 2010, along with all WHO members, we signed the Global Code of Practice on the International Recruitment of Health Personnel, which “encourages countries to improve their health workforce planning and respond to their future needs without relying unduly on the training efforts of other countries, particularly low-income countries suffering from acute shortages”. Clearly, Jeremy Hunt has a lot to do. Explaining why 12,000 British doctors prefer to work abroad might be a good place to start.
David Hughes
Cheltenham
• Polly Toynbee refers to Jeremy Hunt “talking up the scandal in Mid Staffs” in order to “encourag[e] the Care Quality Commission to set higher nursing and doctor numbers per ward”.
The CQC does not set staffing ratios; we make recommendations for practical actions to improve care, based on detailed inspections involving clinical professionals. It is the responsibility of the leadership of individual trusts to determine how best they implement our recommendations in a way that ensures the delivery of high-quality care within the resources available.
Trust boards are ultimately responsible for the future of their organisations and must use the CQC’s reports to help them plan that future – this includes taking a rounded look at staffing. Boards must ensure that there are sufficient medical and nursing staff to meet the needs of patients; it is for them to determine whether this is best done through additional recruitment, or whether demand could be more effectively managed by making changes to their model of care – as we have already seen some trusts successfully achieve. In an increasingly challenging context, the CQC is committed to supporting the NHS in the delivery of good, safe care that is clinically and financially sustainable: the care that we would want for ourselves and our families.
David Behan
Chief executive, Care Quality Commission
• The plan you refer to (Overspent hospitals are told ‘reset’ means they must make cuts or face punishment, 22 July) is another blow in the unspoken agenda to destabilise the NHS. Why not “Underfunded hospitals struggle to provide safe care while budgets are cut”?
The Department of Health has returned an average of £2.5bn a year to the Treasury for the last three years. Why don’t the managers get together and ask for more money, and say they would resign rather than continue to attempt to fulfil the demands of NHS England and the DH? I am told that the average length of stay for a CEO in an NHS hospital is three years, so what have they got to lose?
Portraying the NHS as failing when it is being systematically undermined by government policies in order to bring in the private sector is dishonest and affects those Theresa May said she wanted to help. Can we ask her to look at what has been happening to the NHS over the last six years and apply some radical thinking to restore its funding?
Wendy Savage
President, Keep Our NHS Public
• The easiest way to resolve overspent hospital budgets is just to stop treating patients with minor or non-life-threatening conditions or “voluntary” disorders such as sporting injuries. Patients who already suffer from these conditions should be treated. Healthy people should be advised to take out insurance. No private organisation pretends that it can do more and more with less and less resources. If politicians want to spend money on armaments, railways and nuclear power etc, and to merely write off the cost of their extremely expensive mistakes in the NHS, they must bear the public opprobrium for reducing what can be provided free at the time of use. Professional staff should no longer compromise either their health or their standards by trying to do too much.
Dr Richard Turner
Harrogate
• We urgently need a Labour party that is prepared to undo the damage done to our NHS by successive governments. Cuts, privatisation and opening the NHS up to the market, against public and professional opinion, has made the NHS less safe, less efficient, and at risk of becoming less caring. The Health and Social Care Act 2012 speeded up a process of destruction that had already started. The junior doctors’ dispute, still unresolved, reflects the impossibility of providing the same level of routine services over seven days, when the resources scarcely exist to provide this over five.
So we, as NHS doctors from all branches of the profession, whether we are in the Labour party or not, urgently need an opposition that is united, with clear policies to increase funding to the NHS, repeal the Health and Social Care Act, reverse the privatisations, and get rid of markets in healthcare.
Jeremy Corbyn and his shadow secretary of state Diane Abbott have declared an intention to do all of this, and have displayed exactly the type of decisive leadership the NHS is calling for. We believe the re-election of Corbyn as leader of the Labour party is essential for the very survival of the NHS.
Dr Kambiz Boomla General practitioner, London
Dr Jacky Davis Radiologist, London
Dr Louise Irvine General practitioner, London
Dr David Wrigley Chair of Doctors in Unite, Carnforth, Lancashire
Dr Ron Singer Retired GP, London
Dr Youssef El-Gingihy London
Dr Anna Livingstone GP, London
Dr Yannis Gourtsoyannis Specialist registrar, infectious diseases; junior doctors committee, BMA, London
Dr Aislinn Macklin-Doherty Oncology, London
Dr Pete Campbell Acute medicine, Newcastle
Dr Megan Parsons Junior doctor, Manchester
Dr Jackie Applebee GP, London
Dr Pam Wortley Retired GP, Sunderland
Dr Haroon Rashid GP, Ilford
Dr Saul Marmot GP, Bromley by Bow health centre, London
Dr Sasha Abraham GP, London
Dr Gerard Reissman General practitioner, Newcastle upon Tyne
Dr Sheila Cheeroth GP, Limehouse practice, London
Dr Robert MacGibbon Retired GP, Westleton, Suffolk
Dr Maureen O’Leary Retired consultant psychiatrist, Sheffield
Dr Jack Czauderna Retired GP, Sheffield
Dr Mona Kamal Ahmed Forensic psychiatrist, London
Dr Muna Rashid GP, London
Dr Alex Hardip Sohal GP, London
Dr David Kirby Retired GP, London
Dr Robert Hirst Emergency medicine, London
Dr Iain Maclennan Consultant in public health and retired GP, Sandown, Isle of Wight
Dr Hennah Bashir Emergency medicine, London
Dr Kelly Cruickshank Psychiatry, Salford
Dr Max Thoburn Junior doctor, Manchester
Dr Kathryn Greaves Anaesthetics, London
Dr Shamira Bhika GP, London
Dr Mary Edmondson Retired GP, London
Dr Rishi Dir Orthopaedics, London
Dr Helen Murrell GP, Newcastle upon Tyne
Dr John Puntis Consultant paediatrician, Leeds
Dr Thabo Miller Paediatrics, Somerset
Dr Ben Hart GP, London
Dr Paul Hobday GP, Horsmonden, Kent
Dr Hilary Kinsler Consultant, old age psychiatry, King George hospital, Ilford
Dr Michael Fitchett GP, London
Dr Soraya Boomla GP, London
Dr Kevin O’Kane Consultant, acute medicine
Emma Runswick Medical student, Salford
Dr Coral Jones GP, London
• Join the debate – email guardian.letters@theguardian.com
NHS squeeze can be reversed by applying some radical thinking | Letters
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