YOUR report on your interview with Dr Linda de Caestecker, the outgoing Director of Public Health for NHS Greater Glasgow and Clyde, in its implied criticism of the 2004 medical contract which "boosted salaries while cutting working hours" ("Scotland's 'sick man of Europe' tag could return", The Herald, April 23) inadequately describes the impact of that contract. Nor did this contract have anything to do with the hospital doctors that Dr de Caestecker immediately goes on to say "deserve to get good recompense", a potentially confusing chain of reasoning.
It was a new contract for general practitioners only, giving them the option to stop providing 24-hour responsibility for their patients; in other words, no evenings, nights or weekends on-call. For this reduction in working hours, they would give-up six per cent of their salary, a small cut in income which could be made up by hitting targets under a performance-related bonus scheme and did not deter the vast majority of GPs from taking up the contract. As a result, patients have since had to rely entirely on NHS 111, limited hours-open minor injury units or A&E for any medical problem out-of-hours.
A few years ago, I investigated the possible impact of this contract on A&E attendances in England (Scottish figures were more difficult to obtain, but I don't doubt they would have shown the same picture). Between 2002-03 and 2016-17 there was a 66% increase, from 14.05 to 23.36 million. Over the same period, the population of England rose by only 11% and the proportion of 65+-year-olds by approximately 13%. Nor, surely, could people have been so much more ill in just 14 years. An audit at Barnsley Hospital's A&E, for example, found that only 22% of those attending considered their condition an emergency. The Nuffield Trust reported that annual A&E attendances in England had been remarkably stable at around 14 million from 1987-88 to 2002-03. Something disturbed this equilibrium and it is difficult to see what else could have been more responsible than the 2004 GP contract.
The position is unlikely to have changed and has probably worsened since Covid.
Dr Stefan Slater (retired), Edinburgh.
CMAL MUST EXPLAIN ITS DECISIONS
IT was surely coincidence, but still welcome, that a few hours after you were kind enough to publish my letter (April 22)suggesting that Scottish Government ministers should be putting pressure on CMAL in respect of its decision about securing the services of the MV Pentalina to improve the resilience of the West Coast ferry fleet, a statement posted on the Arran Ferry Committee Facebook page – following a meeting with Transport Scotland, Calmac and Minister Jenny Gilruth – contained the news that on "purchasing or leasing the Pentalina... the minister pushed for a decision on this for future resilience". This represents an engagement in the practicalities of this affair which is a pleasant change after months, years even, of a hands-off attitude by most of her predecessors.
The whole ferry fiasco now resembles nothing as much as the song by Johnny Nash, There Are More Questions than Answers, not helped by the obfuscation inherent in the jumble of acronyms involved, CMAL, Calmac, CFL, which are useful in diverting responsibility, avoiding accountability and confusing the public, even if unintentionally.
But on the subject of securing MV Pentalina, responsibility is clear. CMAL is the Scottish Government agency responsible for vessel procurement, under the aegis of Transport Scotland and it is its decision whether to buy it or not. If it decides against buying it, despite the dire state of the ferry fleet, it must be obliged to explain its reasons, chapter and verse, because the disaster which Arran is currently enduring is almost certain to be repeated somewhere on the West Coast unless additional capacity is secured, while any new vessels are still a long, long way away.
After all the recent mistakes," because we say so" is no longer sufficient; that ship at least, has already sailed.
Sandy MacAlister, Shiskine, Isle of Arran.
IS THAT GORDON STRACHAN? DOGGONE
I ENJOYED reading your article about Gordon Strachan and seeing the young Mr Strachan in his bed from many years ago ("Remember when ... Gordon Strachan was Scotland's hero against Sweden", The Herald, April 23).
I remember in 2014, when Glasgow hosted the Commonwealth Games, my partner and 1 walked up to Mount Florida to the entrance of Hampden Park at Carmunnock Road, to watch the Commonwealth torch being handed on – to Gordon Strachan, who was to run the final distance that day down to Hampden Park. He was charming and talking to those who were standing with him, including a local elderly man with a dog – and that gentleman suddenly realised that it was Gordon Strachan.
He got out his phone camera, and walked up to Mr S, who smiled, and started to stand next to him and put his arm round him ready for the obvious photo; not so, the man pulled away and gave Gordon his camera and told him that he wanted him to take a photograph of him and his dog. We were in hysterics, as was Gordon, who politely agreed, took the phone, and took a picture of the man and his dog. Then a minute or two later he collected the torch from the previous runner, and our local gentleman was obviously happy that he had a picture taken by Gordon Strachan, with no proof whatsoever that it was a celebrity who had taken the shot.
Walter Paul, Glasgow.
WHERE THE BUCK STOPS
IAN W Thomson's letter of congratulation to the new chief of clan Buchanan (April 25) prompts me to mention the fact that the various members of that clan whose acquaintance I have made, admittedly usually native Scots, have invariably pronounced the first syllable of their name as in "bucket" rather than as in "bugle". A classmate in my first year in secondary school and a colleague in my final years at work were both particularly vociferous in correcting anyone who uttered the dreaded "bew" version.
It must be burdensome to busloads of Buchanans to hear their name regularly mispronounced by media presenters and news readers. If any such miscreants are Herald readers perhaps they will take note and mend their ways.
Willie Maclean, Milngavie.
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