Why we must keep our care and health services separate

While UK Government-imposed austerity and neoliberal philosophy, which asserts everyone is responsible for their own problems, has helped create the new breed of uncaring public service manager, the continued attempts by the Scottish Government to integrate care with health hasn't helped. As if the challenge of managing health or social care services was not enough, the Scottish Government now expects managers to do both when Scottish ministers find it difficult enough to handle one brief. Not only are both social care and health very complex in themselves, broadly speaking they involve very different knowledge, skills and philosophies as the people who use services know only too well. Hence the medical model of disability and the social model of disability. Combining the two is an impossible job, hence the alienation of senior managers and their rapid turnover in the Health and Social Care Partnerships.

There is little evidence to support the idea that management can force these two systems together and the failures are well documented in Audit Scotland's reports on "integration". Despite this, and despite being forced by Cosla in the Verity House agreement to accept that local government should retain some responsibility for care, integration is still at the centre of the Scottish Government’s misconceived plans to create a National Care Service. The latest proposed structure is tripartite and will involve the Scottish Government, the NHS and local authorities running a new version of the Integrated Joint Boards. No mechanisms have been proposed that would ensure these new boards and the senior managers who report to them will be any more accountable than the Edinburgh IJB is now.

If Scotland is to avoid these management failures going forward, we need to empower health and social care staff who are on the front line to speak out about what is really happening. Managers should then be required to support that by giving as much priority to needs as to budgets. Integration undermines that possibility by forcing managers to take responsibility for people and services in which they have little or no expertise. Rather than asking managers to do the impossible, we would be far better keeping care and health separate and resourcing frontline services so they have time to work together as required for the benefit of the people who need them.

Nick Kempe (Convener Common Weal Care Reform Group), Glasgow.

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EV fossil fuel claim is false

ALISTAIR Eaton (Letters, February 27) notes that electric vehicles (EVs) need electricity to operate. He then suggests that EVs provoke the use of more and more gas and coal power stations. The facts do not support this.

In 2023, fossil fuel power stations made up just 33% of UK electricity supplies - their lowest-ever share - of which gas was 31%, coal just over 1% and oil just below 1% (Carbon Brief). The UK's last coal power station, 55 year-old Ratcliffe-on-Soar, will close in October this year. The share of our electricity from renewables will continue to increase with the opening of major new offshore wind farms this year.

Furthermore, the total amount of electricity consumed in the UK reached a peak of 375 terawatt-hours in 2005 and has been in steady decline ever since, to about 275 terawatt-hours in 2022 (Statista). This is a dramatic fall. As things stand, there is no link between EVs and fossil fuel power stations.

I would like to remind readers why we are so keen to decarbonise our energy system. It is to eliminate carbon emissions which are creating climate chaos and which will, if left unchecked, destroy human society as we know it.

Jeff Rogers, Banchory.

• ALISTAIR Easton's point that electric cars (EVs) cannot be called "green" while their charging power comes from fossil fuels is well taken.

The international and UK authorities promoting EVs have not thought out of the box as to their practicability and rational desirability.

EVs are, perhaps fatally, flawed by their high purchase and insurance costs, present dependence on heavy subsidies from taxes, range anxiety and notorious charging shortfalls. Current reports show widespread sales stasis and decline.

As with milk floats, their most realistic application is for shortish urban trips.

Lithium batteries' risk of causing near-inextinguishable fires, most serious in highway driving, car parks, tunnels and sea transport obliterates any image of environmental desirability and safety.

As with all dependence on power sources substituting for fossil fuels, EVs cannot yet justify hopes of green desiderata. EVs, like wind turbines, must have seemed like a good idea at the time.

Charles Wardrop, Perth.

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When cars and drivers were tough

 SANDY MacAlister's letter (February 27) brought back memories of early motoring. Always park on a hill in case it wouldn't start and check if there a handy relative en route where the car could be left, or to provide a bed, if the fault was unable to be mended with the bootful of tools and spares that we always carried.

I was not as posh as Sandy, as my first car, a Morris Minor only cost £17 (my pal wanted £20 but he settled for the £17 I had). I managed to cover over 17,000 miles before it bit the dust, including a return trip to Cornwall They, both motorists and cars, were tough in those days.

David Hay, Minard.

Do electric vehicles provoke the use of more gas and coal power stations? (Image: PA)

Blue sky thinking

I ENJOYED David Miller’s note (Letters, January 27) on the jarring use of jargon. I do hope he ran things up the flagpole, pushed the envelope, thought outside the box and scanned the horizon whilst efficiently and effectively managing his day.

I recall the day when I returned from work one evening, my wife asked me what had occupied my day, to which I replied that I had been to a horizon scanning workshop. She took me literally and asked me what I had seen.

Now I must go and circle the wagons for a couple of hours.

Willie Towers, Alford.