Sir, Your leader (“People’s Pills”, Aug 1) highlights the importance of the need for a holistic approach to preventing heart disease and stroke. The adoption of a healthy lifestyle is vital, but many will require pills to counteract the risks of high blood pressure, raised cholesterol and diabetes. We have accepted for decades the wisdom of treating hypertension but for some reason seem reluctant to accept the overwhelming evidence of benefits from lowering cholesterol with statins, which are even more important in preventing heart disease. Now the guidelines recommend treating people at lower levels of risk because the evidence of benefit is unquestionable, the risks are very small and the drugs are cheap.
By combining a healthy lifestyle (stopping smoking, regular exercise, sensible diet) with control of blood pressure and cholesterol levels, the risks for a future heart attack or stroke could be reduced by about 80 per cent. The health benefits to the individual and the economic benefits to society by such interventions are substantial.
Peter Sever
Professor of clinical pharmacology, Imperial College London
Sir, Far more can be achieved through a healthy lifestyle (not smoking, eating healthily, exercising regularly, moderating alcohol and maintaining a healthy BMI) than can ever be achieved through statin prescribing. Doing the former places the onus on the individual to make healthy lifestyle choices and will reduce all causes of mortality and morbidity. The statin option medicalises what is often a lifestyle issue, addresses only one part of a jigsaw and places further burden on an overstretched GP service that is barely coping already.
Dr Simon Hodes, GP
Watford
Sir, The idea of the whole population taking a polypill (statin plus aspirin plus blood pressure lowering medication) has been mooted for years. Yet more research advocating the benefits of everyone taking statins will undoubtedly have a significant effect on already strained resources in general practice. We are also told that statins are completely harmless and any side effects are imagined (the nocebo effect). Your leader suggests that pharmacists may be the appropriate professionals to undertake this workload. I would go further and make them available for people to buy in newsagents and supermarkets next to the cigarettes, butter, crisps and doughnuts.
Dr Andrew Cairns, GP
Petersfield, Hants
Sir, Recently I was on a river cruise and most of the passengers were retired. In conversation with some of the men I found that they were all on statins. I realised then that 20 years ago, before the use of statins was widespread, this cruise could not have sailed. I accept of course that there are other factors, including identification and control of high blood pressure and the discontinuation of smoking.
Gerald Michael (ret’d GP)
London NW7
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Sir, I only know this: that when my husband (aged 81) was on statins for many years his ankles were so huge that he was unable to walk apart from shuffling around the house aided by a stick. Four years ago his doctor took him off all of his medication, including statins. His ankles reverted to their normal size but by then he couldn’t walk at all.
Julia Cross
Clifton, Bristol
GERMAN DISHONOUR
Sir, David Charter’s article about collusion among German car manufacturers (“Why ‘Made in Germany’ is now a badge of dishonour”, July 29) shows that for decades Vorsprung durch Technik has also been Vorsprung durch Cheating.
It poses questions about the culture of the industry itself (why did no whistleblower ever come forward?) but also about that of public bodies. The Bundeskartellamt (the Federal Anti-Trust Office) is, along with the Bundesbank and the Constitutional Court, one of Germany’s most respected institutions. It needs to explain whether it was aware of what was going on; and if not, why not.
Moreover, the European Commission’s Directorate-General for Competition, which prides itself on its independence and rigour and in which German officials have traditionally played prominent roles, needs to be more proactive in investigating such behaviour and not just wait for miscreants to self-report.
Sir Paul Lever
Ambassador to Germany 1997-2003, and author of Berlin Rules: Europe and the German Way
IRISH SEA TUNNEL
Sir, Sir Jeffrey Donaldson correctly emphasises the flow of goods between Northern Ireland and Great Britain (letter, July 29). Expansion of Belfast and London airports will help this internal UK trade. However, we should also build a north channel rail tunnel and thus physically interlink the UK as a whole. The reward would be a much more cohesive UK politically, economically and socially. Passengers and goods should be able to board trains at Belfast bound directly for Glasgow, Edinburgh, Manchester and London.
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On March 23, 1956, the House of Commons debated a proposition on the concept of a north channel tunnel. The imperatives of post-Brexit competitiveness make a more joined-up UK a matter of urgency.
John Barstow
Pulborough, W Sussex
JUDGES’ CODE OF SILENCE
Sir, Sir Alan Moses is persuasive in arguing that the judiciary should now break their “code of silence” and should be prepared to join public debate to maintain their judicial authority (report, July 28). But it would be unwise to accept his advice.
Sir Alan claims that if “judges contributed with greater vigour and clarity to an explanation of the issues involved . . . the ignorance of the criticism would be all the more apparent”. But this is far from self-evident. Just how would it benefit public understanding if judges engaged in debate outside court about the decisions they had made in court? Would that remotely have helped in the Charlie Gard case? Whether they wished it or not, the judiciary would quickly find themselves in the bear-pit of politics and social media, where the heat generated far exceeds any illumination, and abuse has few limits.
Jack Straw
Lord chancellor 2007-10
NURSING BURSARIES
Sir, Rachel Sylvester’s article (“Axing grants for nurses is an act of self-harm”, Aug 1) highlights the “smoke and mirrors” deception of this government. Earlier this week Jeremy Hunt lauded the extra investment in mental health nurse training, yet it seems that much of this will be funded by the cancellation of bursaries for student nurses. This amounts to moving money from one pot to another to show that the government is reacting to the latest crisis. Ms Sylvester’s article shows that the ending of bursaries will be catastrophic for NHS recruitment just when it needs to be at its highest. No doubt, when the damage becomes clearer, another health secretary will come up with another “after the event” plan to show that the government is responding. When are we going to get some solid forward-thinking policies to address the challenges in the NHS?
Tony Fox
Bingham, Notts
TOBACCO DISPLAY BAN
Sir, The report from Stirling University highlighted in your article (“Tobacco firms ‘help stores beat display ban’ ”, Scottish edition, Aug 1) omits to mention the significant efforts taken by convenience store retailers to comply with the tobacco display ban. It also overlooks the impact of the plain packaging of tobacco products, which has been in force in all stores across Scotland since May. The restrictions imposed by the ban are much more severe in Scotland than in the rest of the UK. Along with plain packaging, this means stores simply cannot “promote” cigarettes in the way the report asserts. In Scotland compliance with the legislation has been very high, with at least 98 per cent of stores implementing the ban. The refurbishment of shops with new or adapted tobacco gantries has in fact resulted in the removal of nearly all commercial brand messages and images from the point of sale.
Dr John Lee
Scottish Grocers Federation
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SKYE IS THE LIMIT
Sir, You report that “Crowded Skye may charge £1 to visit” (Aug 1). If only there was some sort of infrastructure in place that could be used to easily collect such a tax. Perhaps a bridge?
Marc Holmes
Middlewich, Cheshire
ROADS GOING TO POT
Sir, Further to your report on potholes (Aug 1), I have just returned from a four-week holiday in France, during which I drove from Calais to Marseille and back, often on country lanes and through small towns and villages. I did not encounter a single pothole.
Simon Pike
Hoarwithy, Herefordshire
STATION OF LIGHT
Sir, I was fortunate enough to have been a young architect working in the office of Sir Richard MacCormac during the design and construction of Southwark station and was very sad to hear of its proposed demolition (letter and report, July 31). The design for Southwark was influenced by Karl Friedrich Schinkel’s stage set for Mozart’s Magic Flute. Despite the station concourse being far below ground, it is flooded with daylight and was envisaged as a humane and civilising space to lift the spirits of weary commuters — attributes not often identified with Tube journeys.
The best Underground stations are not just engineering achievements. The Magic Flute portrays the story of the education of mankind, from chaos to enlightenment. Demolishing such a carefully considered building would be a backwards move.
Mark Hines
Director, Mark Hines Architects
FANTASY PARTY
Sir, Simon Edwards writes that the Conservative Party contains “the worst generation of politicians in its history” (letter, Aug 1). The problem may be that although there are more capable politicians about, they tend to be in the wrong party. A Conservative Party led by figures such as Sir Keir Starmer, Chuka Umunna, Philip Hammond and Sir Vince Cable, backed by Alan Johnson and Kenneth Clarke, might do a lot better, subject to the removal of most of the present leadership.
David Wilson
Bridell, Pembrokeshire
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NOISY NEIGHBOURS
Sir, What Kevin Maher (“Airbnb is fine. It’s the neighbours from hell I hate”, Times2, July 31) fails to appreciate is that the neighbours of Airbnb properties have to put up with all sorts of inconsiderate and noisy guests staying every weekend or, in many cases now, every night of the year. It’s no wonder some of the neighbours appear to be a bit grumpy. You try putting up with it when there is a party going on in the Airbnb hot tub at midnight less than ten metres away from your young children’s bedroom every weekend.
Hamish Gray
Kirkburton, W Yorks
AUSTERITY DRIVE
Sir, In demanding a more luxurious car to reflect the “prestige and status of the mayoralty” the mayor of Dover (July 31) is apparently still labouring under the effects of the white powder he was filmed snorting some years ago, which is unlikely to have been cliff dust. The discomfort of which Neil Rix complains is evidently a consequence of his size, not that of his taxpayer-supplied Prius, and Dover councillors would be well advised to suggest he lose some weight. Public office is about service, not self.
Damian Warburton
Bedford
PRANK HIT FOR SIX
Sir, Although the mutual commentator-joshing on Test Match Special is often enjoyable, I certainly wonder if the on-air trick played by Jonathan Agnew on Geoffrey Boycott was in good taste (report, Aug 1). There is also the problem of the Boycott “100 Hundreds” memorial plate that I immediately smashed in my study wastepaper bucket.
David Day
Ackworth, W Yorks
TRUE LOVE
Sir, Reading the obituary of Jeanne Moreau (Aug 1), I found her described by the following adjectives: enigmatic, cerebral, erotic, manipulative and playful. “Could you manage to be all those at once?” I asked my wife of 53 years over the breakfast table (she is 80). She thought for a moment. “Oh, I think so,” she said. And what’s more, I believe her.
Humphrey Clucas
Sutton, Surrey
Letters to the Editor should be sent to: letters@thetimes.co.uk