Letters: Politicians are not to be trusted with NHS reform

In the current crisis, although health and social care have a crisis of one sort or another every winter, politicians from all the nations are saying they are addressing the issues facing health and care staff, yet these very staff are reporting they do not have the resources that ministers report with the ultimate insult from Matt Hancock being that staff are not using the equipment appropriately and concerns expressed that equipment is being diverted from Scotland to England.

No doubt at the end of this crisis there will be a public inquiry which will run for an extended period of time, not produce any tangible change and allow the current governments in the UK to escape accountability for their incompetence in reforming the health service. At least for the present the health service should be allowed a period of stability and funding in real terms (including inflation, wage rises of staff and the cost of new medications and treatments and the horrendous debts accruing from hospital building) increased.

Bill Eadie, Giffnock.

ANDY Maciver's article on the NHS, though relevant, appears somewhat ill-timed by his own admission and courts controversy in some of its conclusions. With his unstinting praise of Boris Johnson's handling of the pandemic and his selective factual attack on the structures of the NHS, it almost seems that he is absolving the Westminster Government of any responsibility or blame for the unparalleled human consequences of the pandemic this far. His ridiculing of Jeremy Corbyn is petulant and wholly unnecessary at this crucial time and perhaps demonstrates the real purpose of his excoriation of the NHS, namely to save public money in the months and years ahead by fair means or foul.

The Prime Minister's management of the crisis has been lamentable to date. From his laissez-faire, “take it on the chin” and herd immunity ramblings, to his parochial and scandalously ill-judged opting out of the EU ventilator sharing scheme, his Government has appeared ponderous, poorly lead and co-ordinated and utterly mismanaged. Obviously Mr Maciver's rose-tinted view completely ignores this just as he fails to mention the last 10 years of NHS neglect perpetrated by successive Conservative governments. Or indeed, the joy in Tory ranks when refusing nurses a pay rise in 2017 whilst voting for an increase for themselves and passing legislation allowing hedge fund managers to grow even more obscenely wealthy than they already are.

To eulogise the charlatan we have ended up with as our Prime Minister (and I wish him the best of health) and then lambast the very institution that is literally sacrificing its nervous system is irresponsible and chooses to ignore historical context. Calling the NHS our greatest national asset is not to resort to British exceptionalism but to underline the fundamental importance of our healthcare system, particularly at a time such as this. The NHS represents an egalitarian institution that meets the needs of everyone and is free at point of contact. In short, as Nye Bevan said at the foundation of the NHS in 1948, healthcare in this country must be based on clinical need not ability to pay.

Mr Maciver is correct that, like all pillars of the state, the NHS must be reviewed and revised accordingly when this present crisis comes to a conclusion. However, this must be in tandem with a public inquiry that seeks to learn lessons, both in the UK and in Scotland itself, from the policies adopted and decisions made by Government ministers and advisers.

Owen Kelly, Stirling.

ANDY Maciver's comments on health spending imply that Britain spends more per head on healthcare than Norway, Denmark, France and Belgium, with worse outcomes. In fact, we may spend more on publicly funded healthcare but the total spending in these countries is considerably higher than ours. The only EU countries that spend less than us are southern and eastern EU countries.

Our spending on health fell from 9.8 per cent of GDP IN 2013 to 9.6 per cent in 2017. It did not increase under austerity until Boris Johnson released the purse strings prior to the December election. With luck, it might now have regained the 2013 levels.

If Mr Maciver wishes to write a further article, might I suggest he comments on the relationship between poverty, mental health and health outcomes. He could also comment on the serious underfunding of social care throughout the UK which has worsened markedly since 2010 and which is the major cause of bed blocking in the NHS.

(Dr) Sam Craig, Glasgow G11.

WHEN I was 20 – which was quite some time ago – I contracted something which put me in hospital for a couple of weeks. On my medical record the cause was put down to a virus of unknown origin. The hospital I went to, in an ambulance, was the infectious diseases unit at Hawkhead in Paisley, which was originally a TB isolation facility.

It occurs to me that such units would be of use, to put it mildly, today. Hawkhead doesn't exist today. It is a housing development, a fate it shares with others of its ilk in Scotland. The push for centralisation of medical services has seen specialisms brought together in ever-bigger facilities such as the Queen Elizabeth and the Royal in Glasgow. It goes without saying that the introduction of an extremely contagious pathogen like Covid-19 to such concentrated sites is not a good idea. Hence the rush to establish stop-gap solutions like the Nightingales in England and the Louisa Jordan in Glasgow.

Our current affliction with Covid-19 has not come out of the blue. For decades experts in virology have warned that a mutating flu virus was going to result in the kind of emergency we are now experiencing. It was, they said, not a case of if, but when. Bill Gates, the Microsoft co-founder, was listening, even if our politicians weren't. Addressing a TED session in 2015, he said: "If anything kills over 10 million people in the next few decades, it is most likely to be a highly infectious virus rather than a war – not missiles, but microbes. He has put his money where his mouth is and has recently pledged £80 million to fight Covid-19. Time to reassess our priorities?

The Nightingales and the Louisa Jordans, after this particular outbreak is all over, will have to revert to their original use. But the need for such facilities will not be gone. In anticipation of another pandemic, and unless our scientists can develop a universal flu vaccine which has eluded them so far, I think we should be looking back to the infectious diseases isolation units and establishing them again. They may be underused most of the time, but that cost would surely be acceptable against the so-far unquantified, but surely crippling, economic effect of the crisis we now face. These units should be ready and equipped against the probability of future outbreaks.

We certainly were not ready for this one.

Jim Proctor, Paisley.

IN reply to a question at Monday afternoon’s press conference on BBC1 to the Health Secretary (April 14), Matt Hancock stated that there were competitive purchase prices for personal protection equipment (PPE) and that distribution was a mammoth task, thus naming the reasons as he sees it why many doctors, nurses and care home personnel are still risking their lives by wearing inadequate protective clothing while tending the lives of those with the virus.

This is a scandal and compares badly with the measures taken by government when, fearful of the Nazis using gas in the Second World War, issued a gas mask to every man, woman and child in the country with its population of more than 41 million, and all in receipt of the masks when war was declared. That was a truly mammoth task and on top of which government delivered 30 million Anderson air raid shelters to all those with a garden or open space. The mind boggles comparing the two situations.

In an attempt to overcome the delays in distribution by the haggling over prices and who gets priority the Government should commandeer all sources of PPE and store them in a central location administered by a senior officer aided by experienced stores personnel from the three services.

Robert Danskin, Skye.

LIKE David Crawford (Letters, April 11), on March 14 my husband and I returned from a two-week trip to visit family in New Zealand. Interestingly, when we arrived at Christchurch International Airport on February 29 we were greeted by Public Health staff in high-viz jackets who handed all arriving passengers cards advising them of the symptoms of the coronavirus and what action they should take if they experienced any of these symptoms, providing telephone numbers as appropriate. At this point there were no cases of the virus in NZ.

As our 28-hour journey home took us through Sydney and Dubai airports, we fully expected some guidance on arriving at international arrivals at Glasgow Airport. There was no one on hand to provide any information. This seemed hard to believe since at that point two flights daily were coming into Glasgow from Dubai, bringing passengers from many Middle Eastern, Asian and Pacific countries. We decided on the basis of risk we might pose to others to self-isolate for 14 days. One can only admire the way New Zealand has dealt with this crisis in such a positive yet decisive way.

Gill Craig, Glasgow G12.

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