The reform of the NHS and extra funding

This involves two fundamental changes. First, I share the commonly held opinion that partisan party politics must be removed from governance and replaced by a healthcare commission. Second, acute and planned care must be separated. Each city or region needs to reorganise hospital services so that planned care is not continually disrupted by bed shortages as emergency patients flood our hospitals. The private sector works because it treats few emergency cases and planned care is not interrupted.
A J McKay
Eaglesham, Glasgow

Sir, I am by no means rich, but I would be willing to pay something when I use the NHS — a small payment still means that you are accessing the service at a huge discount. I would gladly pay £10 to visit the GP; for specialist treatment I don’t think £75 would be out of order; and a stay in hospital costing £10 a day would not be outrageous.
Harry Katz
Stanmore, Middlesex

Sir, How ridiculous to think that money could “cure” the NHS. The government should look at the money spent on the huge layers of “management”. I spent all my working life within the NHS and witnessed the explosion of “management”. I witnessed them going on golf “away days” during the working week while nursing staff were being reduced by forced early retirement or impossible workloads. The NHS punishes staff at the point of service delivery. Who would want to be a nurse or doctor within this environment?
Helen Burnside
(Retired community nurse manager)

Sir, The tragedy of the NHS is that the whole achieves less than the sum of its parts. This is because the NHS is set up as a series of departments that each have to work to their own incentives and budgets, and these do not include a consideration of how the part contributes to the functioning of the whole.
Dr Peter Davies
Halifax, W Yorks

Sir, Surely the pressure on the NHS would best be relieved by funding local authorities to step up social care and care homes. Then the frail elderly would not be such a burden on A&E departments.
Richard Seebohm
Oxford

QUALITY TRAINING
Sir, It is too early to be consigning the apprenticeship levy to a bin of government skills initiatives that have failed to make an impact on Britain’s skills shortages and workforce productivity (leading article, Jan 23; Comment, Jan 24). But independent training providers agree that apprenticeships can succeed only if the push for growth is accompanied by a commitment that the training is of good quality. The last thing we need is for poor practice to bring the programme into disrepute.

Ofsted should therefore be given the resources to inspect providers. It is, however, concerning that the government has authorised hundreds of new and untested providers for Ofsted to inspect while stopping a similar number of good specialist providers from training apprentices of small and medium-size enterprises.
Mark Dawe
Association of employment and learning providers

HOME SCHOOLING
Sir, Further to your letter “Home Schooling” (Jan 24), it is wrong to presume that children get “input” only from teachers and classmates. Indeed, it is problematic if a child’s social world is dominated by children of their own age — although it does expose them to a pressure to conform, which they must learn to resist.

My children were home educated until they went to state schools for
A levels. They learnt a natural socialising with people of a wide range of ages through things they did. They learnt to ask questions, to investigate, and to think for themselves. They used excellent correspondence courses for their formal examinations. They went on to do very well in school, supported by excellent teachers, and to good universities. They took longer over their education than our school system allows, so they could pursue wider interests.
Paul McCombie
Warminster, Wilts

A GOOD SAMARITAN
Sir, Matthew Parris compares the guilt of not helping snowbound motorists in the Peak District with the Christian analogy of the Parable of the Good Samaritan and ponders how many he might have helped (My Week, Jan 24). In Jesus’s story, we are told of only one victim but there could easily have been dozens.

Rather than stopping for many, perhaps next time Matthew’s undoubtedly good heart could persuade him to stop for just one and, as in the story, take the driver to the nearest pub and buy them a meal — maybe not the overnight accommodation — while they wait to continue their journey.

The Koran echoes this in saying, “Whoever saves a life, it is as though he had saved the lives of all men”, and offers encouragement to us when feeling hopeless watching the plight of others.
The Rev Tim Storey
Telford, Shropshire

RELEASE OF WORBOYS
Sir, If John Worboys has been transferred from Wakefield prison (category A) to Belmarsh prison (also category A), one assumes he has not at any time during sentence been in an open prison (News, Jan 5, and Comment, Jan 23)?

If not, he presumably has not been going out to work from a category C/D prison? All lifers must go through this decategorisation process to test out their risk. They will, in open conditions, go out into the community for many months, returning to their prison each evening. Regular drug and alcohol tests are done on their return to prison. They expected to work, or go to college. Any deviation from good behaviour in the community results in an immediate return to closed conditions.

They spend periods of leave in the hostel to which they will go on release. The victim/offender unit is in regular contact with the victims, who should be informed of the prisoner’s progress. If this has happened, release should come as no surprise.

However, there is no evidence that any of these factors have taken place. If not, why not?
Liz Brereton
(Former probation officer)

A STAB IN THE BACH
Sir, With regard to Sue Rawlinson’s letter (“Rude departures”, Jan 23) concerning audience members leaving concerts early, we performers have long grown used to the “London standing ovation” as punters dash for the exit. It seems to happen only in this city.

I remember one occasion at the Royal Festival Hall when my colleagues and I were performing Bach’s St Matthew Passion with one singer to a part — a monumental effort in such a space.

As the orchestra began the final chorus, I watched with incredulity as a woman in the stalls right in front of me gathered up her coat and multiple plastic bags and shambled up the steps towards the door.

I sang the opening words of the chorus “Wir setzen uns” [We sit down] at her back with
renewed vigour.
Roderick Williams
Kineton, Warks

A BRIDGE TOO FAR
Sir, Further to your recent reports, and letter (Jan 22), on the building of a Channel bridge, the Dover Strait is the world’s busiest maritime thoroughfare. Dense fogs, limiting visibility to 100m or less, are common throughout the year. Many of the world’s largest tankers, constrained by draughts of more than 20m and large turning circles, pass through daily. There is a powerful tidal stream.

To add the hazard of fixed bridge structures is asking for a disaster for the ships, the environment and the traffic on the bridge.
Peter Adams
(Master mariner)

Sir, Having had reason recently to look into the price of taking the car ferry between Portsmouth and Fishbourne, may I suggest that Mr Johnson gets in a little practice
by building a bridge to the Isle of Wight?
Stephen Bamforth
Halloughton, Notts

POLITE NOTES
Sir, I am disappointed to note the suggestion that social convention still requires thanks to be in writing and not by email (Ann Treneman, Notebook, Jan 23) — to the extent, indeed, that a letter, however long delayed, is preferable to an email, however prompt. Personally, I would rather be thanked early and legibly than to be left wondering for weeks whether the gift arrived or the hospitality was enjoyed.

Nowadays I usually email my thanks. Have my standards slipped unacceptably?
Lord Brown of Eaton-under-Heywood
House of Lords

TEENAGE PASSIONS
Sir, How can a head know so little about teenagers (“Top school bans pupils from having relationships”, Jan 24)? Does he not remember how overwhelming first love is? Forbidding romances will cause the sort of pain that young people find difficult to cope with and be detrimental to academic performance. Allowing it under controlled conditions will bring happiness, which is conducive to learning.
Marianne Lederman
Hitchin, Herts

DEGREE OF SUCCESS
Sir, Further to your report “Pay more for a degree that doesn’t get you into work” (Jan 23), Robert Halfon is clearly not a medieval history graduate. As one, I would like to assure him that the skills my degree gave me — assimilating varied material, cohesive argument and a love and understanding of the past — have helped me in my teaching career. Then again, Mr Halfon may not consider teaching to be something that the country needs.
Olivia Bicknell
London SW13

TAXING PUPILS
Sir, I write further to your letters on school sarcasm (Jan 23 and 24). During my brief teaching career I more than once wrote on a school report: “Your son is trying.” It seemed to satisfy the parents just as it did me.
Trevor Osbourn
Saffron Walden, Essex