I pity the civil servants in the Department of Health who are forced to give platitudinous responses to the press (Leak reveals doubts over ‘seven-day NHS’, 23 August). In 2012 the then secretary of state for health, Andrew Lansley, fought tooth and nail (using taxpayers money) to hide the risk assessment done before the disastrous health and social care bill, despite intervention by the information commissioner. There, the “worst case scenario” has occurred after the passage of the Health and Social Care Act 2012. Civil servants are right to be worried that there is not enough money or sufficient trained staff available to carry out the policy, as there is insufficient money to run the NHS as it exists, providing a five-day elective (planned) and seven-day emergency service.
The lack of detailed planning of the proposed service is analogous to the way the Cameron government approached the EU referendum. What the NHS needs is more money to deal with rising demand, which could easily be found by scrapping the wasteful tendering processes which have resulted in almost £20bn of contracts going to the private sector since 2013, reviewing PFI debts costing over £2bn per year, reducing expenditure on the CQC, which has become unwieldy but arguably has failed to prevent hospital disasters, and reducing the six-figure salaries that too many top managers are now paid. Private contracts are expensive and have not yielded the promised innovation or improved services.
Wendy Savage
President, Keep Our NHS Public
• Most people will agree that the NHS is the jewel in the crown of British life and prized by almost everyone. David Nicholson wrote on his retirement as chief executive of the NHS, “It is built into what it is to be British” (Sunday Times, 2 March 2014).
Yet it is “threadbare, scrappy, perilously understaffed and barely held together by legions of nurses, doctors and allied health professionals” (These leaks show Hunt’s deception on the seven-day NHS, 23 August).
As a retired NHS physician and former independent MP, I talk to many people about the NHS and, without exception, they would willingly accept an increase in income tax, if it was hypothecated to the NHS, and if all measures for increasing efficiency and economy within the NHS had been adopted.
Would the Guardian consider carrying out a survey of its readers to assess the support for such a measure to rescue our beloved NHS?
Richard T Taylor
Kidderminster, Worcestershire
• You report that NHS England expects local doctors, hospitals and councils to work together in each of 44 “footprint” areas for the “first time on shared plans” (Revealed: plans to fight NHS deficit, 26 August). We recall how, in a 1968 green paper, health minister Kenneth Robinson proposed just such area health boards, to meet his paramount requirement that all the different kinds of care and treatment should be readily available to the individual citizen. We, who were involved in the preparation and promotion of those novel ideas in 1968, can but hope that our successors will get past the green stage.
Dora Pease and Tim Nodder
Ministry of Health long-term study group 1967-74
• Save Our Hospitals: Hammersmith and Charing Cross has been campaigning for more than four years against the downgrading of hospitals in north-west London, where we have already lost two A&Es, with dire effects on other A&Es in the area, and where two further major acute hospitals, Charing Cross and Ealing, are to be downgraded to as yet undefined local hospitals. As you note, these hospitals will be little more than glorified urgent care centres (Councils reject plans to ‘transform’ NHS, 26 August).
Already all hospitals in NW London are working at full capacity, failing to meet A&E targets, and with accelerated population growth in NW London, out-of-hospital care is even less likely to meet the health needs of our local population.
For four years we have been asking the local health authorities for the evidence that the proposed out-of-hospital provision can replace acute in-hospital care. For four years we have been promised this evidence. And for four years we have been presented with no evidence that suggests the changes can work.
It has become increasingly clear that financial considerations are driving the plans for this new top-down restructuring of the NHS. The outcome will be even greater privatisation of the NHS.
That two council leaders have been prepared to stand up to the NHS bullies and reject this attack on local health provision and local democracy is admirable. We know that the leaders of Hammersmith & Fulham and Ealing councils have the support of the local population as well as local campaign groups.
Merril Hammer
Chair, SOH: Hammersmith & Charing Cross
• Among your articles on the “sustainability and transformation plan” for the NHS, you mentioned the current efforts to remodel healthcare in North, West and East Cumbria. My local community hospital is threatened with removal of all inpatient beds. Alston Moor is a sparsely populated area of high moorland with four of the five roads leading over high passes; all are slow, frequently impassable in winter. The nearest hospitals are 20 miles from Alston, another five miles for some parts of Alston Moor; the nearest main hospital is over 30 miles away, in Carlisle. There is no meaningful public transport; even by car, it takes 40 minutes to the smaller hospitals, an hour to Carlisle.
If there are no inpatient beds, there will be no nurses. If there are no nurses, there will be no nurse-led minor injuries unit, and all will have to get to A&E in Carlisle. Without the hospital, our GP surgery is not viable (the relatively low returns of GP services for a mere 2,000 people are supplemented by the hospital work).
What family will want to live here with children if there are no medical services? Without children, our schools are doomed. What older person will want to live here knowing that their dying days will be spent in a hospital far from family and friends? What carer will cope with the burden of their task with no respite care?
How can it be OK to destroy a community? First they came for the small rural communities and I did not speak out because I did not live in a small rural community…
Alice Bondi
Alston, Cumbria
• Join the debate – email guardian.letters@theguardian.com
Local difficulties in the cash-strapped National Health Service | Letters
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