Health center

Health center 23th May 2013

I trot round the park today and listen to the Navy lark. I Oh dear, oh dear
Lt Murray is having problems woth Rita kins. Meanwhile Troutbridge is to set sail for Hong Kong with a top secret new navigation device on board. Will the fiendish Master get his hands on it? Priceless.
A quiet day off out to the health center with Mary, I sell a arts and craft book.
The Fosdyke saga: Fleur and Soames and Irenie who never ages and the American wife all mixed up oh and John and soames’s sister …
Mary wins at Scrabble today, just and gets just under 400, I might get my revenge tomorrow, I hope.

Obituary:

Mick McManus
Mick McManus, who has died aged 93, occupied a place in the pantheon of post-war British wrestling equalled only by those supersized Spandex-clad stars Big Daddy and Giant Haystacks.

Mick McManus  Photo: REX
6:23PM BST 22 May 2013
Like Haystacks, McManus adopted a notably villainous persona. Sporting a precise thatch of lacquered black hair, he cultivated audience hatred with sneers and positively relished the catcalls and jeers that accompanied his every devilish trick in the ring. But unlike other villains – “heels” in wrestling terminology – McManus almost invariably won his bouts.
This run of success baffled some onlookers, who failed to discern particular grace or skill in the carefully choreographed half-nelsons, short-arm jabs and Boston Crabs with which he forced his opponents to submit. He was not tall (just 5ft 6in) nor intimidatingly large – though well-upholstered, his fighting weight was a mere 12st 5lb. His most potent weapon was possibly the fact that he was a “booker”, organising fights with Dale Martin Promotions. As such, he ensured his own prominence on wrestling bills well into his fifties, sometimes to the chagrin of his adversaries.
Yet to the British viewing public, flocking in ever greater numbers to their television sets, such details mattered not a jot. Introduced by Dickie Davies, ITV’s World of Sport became a Saturday afternoon institution. And though the show had segments on football and racing, it was the wrestling, beamed to homes around the country from municipal halls in Wolverhampton or on the Old Kent Road, that proved the biggest draw.
Within the sport there were few bigger draws than McManus himself, particularly when he developed a lasting grudge with wrestling’s “Mr TV”, Jack Pallo. Their rivalry was played out in bouts on FA Cup Final day in 1963 and 1965 which, according to legend, drew more viewers than the football itself. A third showdown was staged at the Albert Hall in 1967. Each man had his own weakness: Pallo hated being pulled by his ponytail; McManus would routinely beg: “Not the ears, not the ears”.
Theirs was an unlikely sporting partnership that, like that of Torvill and Dean two decades later, somehow managed to capture the national imagination. “They used to go potty for us when I fought Mick,” Pallo once said. “Why? Because we were both very good. You can’t beat the quality. Mick had that know-how: a great performer. Horrible bastard, but a great performer.”
McManus was born William George Matthews in London on January 11 1920. He grew up in New Cross and, having left school at 16, joined a weightlifting club managed by Fred Unwin. Known professionally as the Pocket Hercules, Unwin was a regular lightweight on the wrestling circuit and encouraged William to enlist at the John Ruskin Amateur Wrestling Club in Walworth, where he could learn the basics of the art and build up his strength.
From 1948 he began wrestling professionally under the Dale Martin group. According to Max Crabtree, the promoter and brother of Shirley Crabtree (aka Big Daddy), Matthews, who by then had adopted the name Mick McManus, also had a crucial role in the Dale Martin office. “He did the data sheets, the matchmaking. If you annoyed Mick, you might find that you only got two dates in February.”
For the same reason, McManus himself was never short of work. His ring career lasted more than three decades, until he retired in 1981. He then concentrated on promotion full-time, working in public relations and making appearances at golf days and corporate functions. Though renowned as a “hard man” without heart, many of his appearances were for charity.
Mick McManus, who wrote a wrestling column for The Sun, also produced the Mick McManus Wrestling Book (1970).
His wife, Barbara, died earlier this year.
Mick McManus, born January 11 1920, died May 22 2013

Guardian:

Dave Welsh (Letters, 21 May) says the London underground has been publicly owned for 80 years; it was actually nationalised, along with the rest of the railways, by the Attlee government in 1948. The London Passenger Transport Board of 1933 had a complex structure. A small proportion of its stock was held by the London county council and other local authorities by way of payment for their tramway networks. But most of its stock was held by private shareholders and traded on the stock exchange.
While the underground did receive some government financial assistance in the 1920s and 1930s with the guaranteeing of loans to finance new construction, it received no subsidies at all, let alone “lavish” ones. The GLC took over London Transport in 1970, not 1968.
As Mr Welsh says, successive recent governments have struggled to find a sustainable way of funding the Underground. Gordon Brown’s PPP was a huge and costly failure. In a rational world it should have been the final nail in the coffin of all private finance initiative projects, but that is not the world we inhabit and I fear that before long another government will try to find a way of privatising the underground that will be much less benign than the pre-1948 private ownership.
Andrew Robertson
Knockholt, Kent

Jack O’Sullivan makes some very important points about the clear difficulty around discussing what men experience and how the post-feminist settlement leaves out matriarchal influences and power relations in the domestic space (A man walks out of a room, 21 May).
For men, feminism has been a gift in how it has opened up new ways of being a man, but it has also left men facing the psychological quandary of how to “be”, in response to what has changed. This applies particularly in the home, which, in the conventional heterosexual formulation, is still predominantly defined by women. In my view we have a long way to go before we understand male development and behaviour. Many men are still caught by the tensions inherent in mother-son relationships: part of them yearning for relationship, another striving to define their gendered identity as separate from her. Despite all the commonalities, male development, and attachment patterns, from infancy onwards is not the same as that of females, and we need to face the reality of how this impacts on home life in adulthood as well as how we seem to assume that early-years and primary education should remain a predominantly matriarchal space in the same way that many of our homes are.
What Diane Abbott has spoken to as a crisis in masculinity goes much deeper than its social and interpersonal manifestations. We need a narrative about male development that helps us to make sense of the problems boys and men face (and how girls and women are also affected by this) in the same way as feminism provided a narrative for women. This also needs to be a narrative that makes it OK for men to critique feminism without feeling scared of the reaction they might get.
Dr Phil Goss
Senior lecturer, counselling & psychotherapy, University of Central Lancashire
• Jack O’Sullivan’s article is a welcome and perceptive contribution to highlighting men’s issues.
What the author misses, however, is that all over the western world men are in fact meeting together to discover and practice more wholehearted and authentic ways of being, and that these initiatives are barely represented in the mainstream media. The chief reason for this is not that men fear ridicule from women for talking about masculinity, or that matriarchy has a lot to answer for, but that other men, and especially in Britain, and particularly journalists, are very fearful of anything they imagine is connected with “tree-hugging”. At our centre we are frequently asked by women what groups and events we have for their husbands sons and even fathers. Britain lags behind here. In fact this weekend, a group of men from all over Europe are meeting near Frankfurt in an International Symposium for Men in order to share the different ways being pioneered of working with men’s issues. Lamentably, Britain boasts the fewest number of participants, which has to do with the way our culture regularly practices ridicule towards those who are willing to express that they care about things that are beyond others’ understanding.
John Bunzl Founder, International Simultaneous Policy Organisation, Nick Duffell Co-founder, Centre for Gender Psychology

I hope the Foreign Office is not being persuaded that supplying more arms into Syria will be a constructive solution to the problem (All sides in Syria armed except the good guys – Foreign Office, 16 May). In 2005 the United Nations adopted the doctrine of the “responsibility to protect” populations from mass atrocity crimes, and since then this commitment has been severely tested, especially in the current Syrian conflict. The UN envoys Kofi Annan and Lakhdar Brahimi have tried to negotiate a peaceful resolution but UN member states have supplied arms to the parties to the conflict. Many experts, exemplified by Jeremy Greenstock (The civil war is still to come, 16 May), consider that the solution to such conflicts must be through developing better mechanisms for encouraging a negotiated settlement. Only a few weeks ago the UN general assembly overwhelmingly agreed an arms trade treaty that is intended to prevent the supply of arms, especially where there is an embargo, to people who are likely to use them in breach of humanitarian laws. We need to be encouraging member states to give greater support to the UN and its peace-building initiatives, not find ways to undermine them. The United Nations Association of the UK, at its recent policy conference, called on the UN and its members to put more resources into such peace-building initiatives and to move rapidly to a strong implementation of the arms trade treaty. I hope the UK government will continue to support these principles.
Trevor Evans
Chair, Harpenden United Nations Association
• Jonathan Steele (Syria’s chance for change, 21 May) argues that prospects for a negotiated solution to the Syrian conflict have been enhanced because the main players have recently adopted more reasonable positions, claiming “Assad has dropped his demand that the armed opposition lay down its guns before he sends his people to meet them”.
However, in his recent interview with the Argentinian newspaper, Clarin, Assad insisted that no state can negotiate with “terrorists”. In case there should be any doubt about the import of this view, he explicitly stated: “We would engage in dialogue with all political entities, internal or external with no set pre-conditions. This also includes the armed groups who lay down their weapons and renounce terrorism. Guns and dialogue are clearly incompatible.”
He was also adamant that he will retain the presidency – and hence control of the regime – at least through to the election scheduled for 2014. So the real Syrian position is: no negotiations with the armed opposition; and nothing other than cosmetic changes to the regime for the foreseeable future.
Not a very promising starting point for achieving a negotiated settlement.
Brian Slocock
Chester
•  It seems as if the best solution to the problem is to support the multi-sectarian secular regime of Assad and join with them in fighting the Sunni extremists. The result would be a reunified Syria, allowing refugees to return and the suppression of the Sunni extremists. The best that could be hoped for after an intervention would be something like the government left to Iraq, not an encouraging thought. And that would be after a war. At what point would the interveners declare the rebels the enemy?
Paul Baker
London

The new British space race (To boldly go, G2, 21 May) has the potential to inspire young people and boost our economy. Space travel captures the imagination of budding young inventors and engineers – it is the stuff of childhood dreams. But there are other British industries at the forefront of technology that can inspire and propel young people towards careers in engineering and science. Without changing the way we teach, they will pass children by.
Engineers have designs on the future: fuel cells, driverless cars and super materials. Material scientists, for instance, delve into the depths of space at a micro-level, increasing the possibilities of product design and engineering. But children do not see this side of engineering. For them, engineers are men in greasy overalls fixing the boiler. We must bridge the gap in understanding – to plug the shortage of 40,000 science, technology, engineering and mathematics graduates every year.
Our design and technology curriculum must reflect the potential of a career in engineering. Our foundation has worked with secondary schools in Bath, donating industry equipment and setting pupils briefs to make something with a purpose – much like in industry. It connects the idea that engineers design something tangible. The results have been startling, with more than twice the number of students signing up to study design and technology. A world class D&T curriculum that fuels young astronauts and aeronautical engineers alike would replicate this on a national scale. The results could be quite remarkable – getting Britain inventing again.
James Dyson
Founder of Dyson and chair of the James Dyson Foundation

I now know what the implications are for the new “reformed” NHS when I recently received an unsolicited letter selling me health insurance in order “to avoid NHS waiting lists, [and] gain access to the latest established treatments and approved drugs” (Report, 22 May). What a prospect for the future health of the elderly.
David Selby
Winchester, Hampshire
• So Nick Clegg is exasperated that “parliament is being clogged up by issues such as Europe and gay rights” when we’re facing “the most profound economic challenge in living memory” (Report, 22 May). He didn’t seem to mind when it was being Clegged up over House of Lords reform or the alternative vote.
Jeremy Beecham
Labour, House of Lords
• Mark Lawson is a mere stripling compared to many diehard fans of the late, great Tony Hancock (Eric and Ernie owed their laughs to Eddie, 22 May). However, they would be able to tell him that Hancock uttered the line “he won’t sell many ice-creams going at that speed” about 20 years before it was included in an Eddie Braben script. Of course, in the 50s police cars used bells rather than sirens.
Christine Lock
Wokingham, Berkshire
• Tubular Bells was the first LP I bought for my new stereo system (How we made … Tubular Bells, G2, 21 May). I was having difficulty sliding it over the spindle and my husband remarked that it was only to be expected from a Virgin record.
Lesley Kew
Falkirk
• Anne Galloway (Letters, 22 May) has clearly never come across the rock band Spinal Tap. Their drummer Eric “Stumpy Joe” Childs died after choking on vomit which was not his own. The source of the vomit was never satisfactorily established because Scotland Yard didn’t have the facilities. As lead guitarist Nigel Tufnel famously commented: “You can’t dust for vomit.”
Mark Redhead
Oxford
• I have thought short and soft about journalistic cliches (Letters, 22 May) and, after undue consideration, I think you should call it a night.
Tom Swallow
Kenilworth, Warwickshire

CBI president Sir Roger Carr’s claim that there can be no moral basis to concerns about tax avoidance is a grave misjudgment (Never mind morals, tax is all about the rules, 21 May). A great many ordinary people see payment – or rather non-payment – of tax as fundamentally a moral question. Perhaps it might be talked about as justice or fairness, but it boils down to the same thing. Christian Aid supporters have been campaigning on matters of tax justice for five years.
At the heart of their concern is the moral question of how societies raise revenues and how that money is spent. We estimate that developing countries lose around $160bn a year in tax revenue from multinational corporations. Contrast this with the UK’s aid budget (£12bn) or the UN’s Food and Agriculture Organisation’s estimated cost of tackling global hunger ($50bn a year on top of existing funding to 2025). The fact that tonight one in eight people in the world will go to bed hungry shows that the moral case for a fair and just taxation system is undeniable.
Canon Geoff Daintree
Church advocacy adviser, Christian Aid
• Simon Jenkins is spot-on when he calls on David Cameron to crack down on the UK’s own tax havens (Comment, 22 May). Global Witness’s investigations have found numerous examples of dodgy deals routed through places such as the British Virgin Islands, favoured by tax evaders and corrupt dictators. There is often a misperception that the UK can’t impose its will on these last outposts of empire. In fact, from the decriminalising of homosexuality to banning the death penalty, there are repeated examples of UK governments telling its tax havens what to do, sometimes against their will. After Radio Caroline started broadcasting from the Isle of Man, the UK banned pirate radio stations from there and from the Channel Islands.
If the PM really wants to crack down on tax evasion, corruption and money laundering, he should force the British-linked tax havens to lift their veil of secrecy, for example by requiring them to publish the names of the ultimate owners of companies and trusts registered there.
Robert Palmer
Campaigner, Global Witness
• Paying tax is a social obligation. It is the price we pay for being part of a civilised society and one defining characteristic of such is its willingness to support those who are not considered to be economically productive. This doesn’t just mean the unemployed, the sick, disabled and the old, but also artists, musicians and writers, those who enrich us and our society both intellectually and emotionally.
In the commercial world, businesses view taxation as just another cost of doing business and therefore within their fiduciary responsibility to seek ways of reducing their tax obligation as part of their cost base. This is wrong. The payment of corporate tax should be viewed not as a cost of doing business but as the price for gaining access to society.
Businesses that manipulate the tax rules to reduce or avoid paying tax impoverish the society in which they operate both financially and ethically. Good corporate citizenship requires the commercial world to fully engage in society – by making a fair and equitable contribution to the tax receipts of a nation and by paying its employees an appropriate living wage.
Mike Kellett
Cardiff
• In 1974, the then Tory prime minister, Edward Heath, called an election with the question Who governs Britain? – his premise being that the unions had too much power. Forty years on we can ask the same question in respect of big business (Cut tax and we’ll pay, says Apple boss, 22 May). I thought governments, elected by their peoples, decided tax rates. Apple (and Google, Amazon and the others) rely on their customers to be healthy and well-educated and for the states where their customers live and buy their products to be stable, orderly and defended.
Without all the benefits that a state provides there would be no Apple sales. Big business has grown increasingly arrogant and no longer plays and pays its part in contributing to the costs that are essential to their profits. Perhaps there should be an additional and hugely hefty tax on the products of those companies who are refusing to pay their way, so that in the end they are left with no profits to quarrel about.
Mark Doel
Sheffield

Independent:
+More
The range of responses by the men interviewed in your feature to the question of whether there is a “crisis of masculinity” is striking (20 May). We should welcome the opportunity afforded by Diane Abbott’s speech to have a discussion about the problems facing men and boys in  21st-century Britain.
For men, feminism has been a gift in how it has opened up new ways of being a man, but it has also left men facing the psychological quandary of how to “be” in response to what has changed. This applies particularly in the home, which, in the conventional heterosexual formulation, is still predominantly defined by women.
In my view we have a long way to go before we understand male development and behaviour, and while father-son relations are really important, understanding how boys are influenced by their relationship to their mother is equally crucial.
Many men are still caught by the tensions inherent in mother-son relationships, part of them yearning for relationship, and another striving to define their gendered identity as separate from her.
We need a narrative about male development which helps us to make sense of the problems boys and men face, in the same way as feminism provided a narrative for women, and this needs to be one which makes it OK for men to critique feminism without feeling scared of the reaction they might get.
Dr Phil Goss, Senior Lecturer, Counselling & Psychotherapy, University of Central Lancashire, Preston
No wonder there’s a crisis in masculinity. See the media coverage of the retirements from football of Fergie and Becks. The former is celebrated for his rants; the latter his pants.
Dr Alex May, Manchester
Why are patients crowding  into A&E?
In an emergency, I believe that most patients would feel more confident if they were able to access their GP, rather than try to communicate with some disembodied voice on the end of the phone (“Top A&E doctors warn: we cannot guarantee safe care”, 21 May).
Perhaps the GP contract of 2004 is part of the problem, though it is difficult to see why it has taken so long for the strain on A&E departments to become apparent.
There are other factors in play, one of which is the difficulty in staffing these departments with doctors committed to specialising in this very stressful environment.
GPs must be brought back as the first point of contact in the care of emergency cases. They will require some financial inducement, and in the present economic climate may be inclined to strike a hard bargain.
E A Benson, Retired Consultant Surgeon, Brighouse, West Yorkshire
My experience may throw light on some of the problems faced by A&E departments.
When I retired from an outer London hospital paediatric consultant’s post five years ago, we looked at the figures from my first year in 1976 compared  with my last. Almost exactly the same number of children were admitted to hospital, but just over 10 times as many were seen and sent home  from A&E. The peak numbers were during the usual evening surgery  times for the local GPs.
The number seen continues to grow and must reflect parents’ changing attitudes both to coping with their children’s minor illnesses and to using their family doctor services.
Dr Peter Jaffe, London W5
“What Hunt wants to see is a system where GPs are rewarded for looking after patients when they are ill and when they’re well” – The Monday Interview, 13 May.
In my student days, a Chinese friend from Hong Kong would regale me and those around us with many a tale from his homeland to illustrate the differences between our countries,. On one occasion I recall him telling us how medicine used to be practised in ancient China.
A physician would be contracted by someone to see to their health needs, in return for the regular payment of an agreed amount. However, should illness arise, all emolument would cease until the complaint was overcome.
Something for Jeremy Hunt to ponder in the coming months?
Simon Parkinson, Dewsbury, West Yorkshire
Travelling north and south
Your third leader (17 May) notes the NAO’s “harsh judgement” on HS2. It’s not unreasonable to question the prudence of proceeding with HS2, even though it’s a practical and well-prepared project. However, why on earth do you then link your point to the reckless fantasy of Boris Island, for which no detailed costs exist and which would entail writing off 70 years of investment at Heathrow? 
May I ask you also to point out to your cartoonist that trains can readily be procured that will run on HS2 and then proceed to Liverpool, Newcastle, Edinburgh, Glasgow and many other places, spreading the benefits to northern England, Scotland and North Wales.
Roger Davis, Peterborough
R Goodall (letter, 14 May) writes that London sucks up UK infrastructure spending. I would invite him to take a trip round the M25 to junction 7 and try accessing Croydon. A piece of dual carriageway quickly narrows to a one-lane A road with 20 sets of traffic lights, leading to a journey of over an hour to cover five miles.
Or take a trip down the A21 out of London towards Hastings, with initially two lanes of traffic bowling along at reasonable speeds, until one reaches Pembury, at which point the dual carriageway feeds into a 14ft-wide country lane, with the predictable huge traffic jams. These bottlenecks have been known for years and not a penny has been spent.
In contrast, a trip to Sheffield, Leeds, Glasgow, Coventry etc sees traffic delivered on fast reliable dual or triple carriageways into the centre of the city without a single traffic light. I think the regions have done far better on infrastructure spending than London.
Paul Ives, Sanderstead, Surrey
Officials part mother and child
I find myself increasingly ashamed to be a citizen of a country which treats those outside its borders so badly. Recently I met a PhD student at a British university with which I am associated.
She is a citizen of a Commonwealth country in southern Africa. A few months ago she was awarded a Commonwealth Scholarship to study in the UK for the three-year duration of her PhD.
She applied for visas to enable her children to accompany her. Her husband is studying full-time in another country in Africa, so she was going to have to endure that marital separation. Leaving her children behind however was not in her plans. The children range in age from one year to eight years.
The visa applications cost her $300 per child – a huge sum for one living in her country. I was deeply disappointed, though not surprised, when she told me that her application for visas for her children had been turned down, and I was even more ashamed of my country’s heartless immigration apparatchiks when I heard the reason given. “They told me that my husband could look after the kids”, she said, “something which simply isn’t culturally acceptable in my country”.
Who are our immigration officials to play God and decide that a mother should be separated from her children for three years? Are they really afraid that three children of one, five and eight years are going to take “our” jobs?  Will they be a drain on “our” benefits and health and education systems? How heartless can they be to separate a mother from her one-year-old?
Richard C Carter, Ampthill, Bedfordshire
Drama at the Scottish border
Elspeth Christie of Northumberland (letter, 18 May) need not worry too much over the future of the booze cruise. When Scotland breaks away from  the UK and joins the EU at the same time as the disunited Kingdom leaves Europe, she will be able to pop up to Berwick-upon-Tweed, cross the new land border with Europe and go into one of the many supermarkets set up to profit from the auld enemy’s insatiable thirst for cheap booze.
She may, however, have a long wait to cross back into England as she will have to queue up alongside all those Europeans who can no longer gain entry into England but who have entered Scotland without let or  hindrance and then just head south to the greener pastures across the border. Those who have the misfortune to be stopped and sent back will no doubt sign up to one of the many new companies organising walking tours across Hadrian’s Wall.
John E Orton, Bristol
Gay marriage: the Tebbit test
Lord Tebbit has raised the spectre that gay marriage might give rise to situations where lesbian queens use artificial insemination and fathers marry their own sons. One can scarcely imagine what the product of generations of this sort of inbreeding might look like…
Julian Self, Milton Keynes
In the light of the Conservatives’ displeasure at the law allowing same-sex marriage, may I suggest a new slogan for the Tory party: “Conservatives tolerate gay people – as long as they’re not married.”
Henry Page, Newhaven, East Sussex
Please could someone explain to those of us who are neutral on the subject, and would like a better understanding, what are the key points of difference between a register office wedding and a civil partnership?
Pat Johnston, Fourstones, Northumberland
Politicians make the tax laws
I am getting bored seeing committee rooms full of posturing politicians trying to divert attention from their own failures. Companies such as Google, Amazon and Starbucks are behaving within the tax laws. If politicians don’t like this then it is their responsibility to make changes.
Dragging senior company figures before Parliament is convincing nobody. The failure to collect decent amounts of tax is the fault of the politicians who define the laws.
Paul Harper, London E15
If Christopher Anton (letter, 22 May) is serious in his boycott of Google I suggest that he uses an alternative search engine, then he won’t see any Google adverts. Unfortunately my company cannot be so choosy, with Google monopolising search engine use in the UK – over 80 per cent use it, a higher proportion than any other country.
Rob Phillips, Bristol
Keep walking
There may well have been a major shift in attitudes of parents to allowing their children to walk to school (report, 20 May), but the evidence presented is far from convincing. It seems 81 per cent of children formerly walked to school, but now 27 per cent are driven. So the proportion walking has dropped from 81 per cent to 73 per cent – surely more of a minor shift.
Alfred Venables, Cardiff

Times:

Sir, I have worked in several senior management roles overseeing GP Out of Hours (GP OOH) care in the public and private sectors before and after the 2004 contract change (report, May 22). Post the contract change in 2004, access, not necessarily quality, was dramatically improved. The number of patients being seen out of hours increased nationally by millions, which resulted in GP OOH having to increase the clinical workforce to meet demand. Instead of improving the provision of urgent primary care needs out of hours the post-2004 system has generated a climate within which patients seem incapable of looking after themselves. The improved access has resulted in a plethora of choices for the individual, choices which were not available when patients were encouraged to use services appropriately.
A review of local OOH’s activity during December 2012 initially indicates that 30 per cent of total out-of-hours contacts were not urgent and could have waited until the patient’s own GP opened in the morning. Firm action needs to be taken in educating patients on appropriate use of such services. NHS establishments need to become less risk averse and inform patients that they will only be treated in appropriate settings.
A sobering thought is that the inappropriate use of healthcare services directly impacts on those patients who need urgent medical attention.
Chris Cashmore
Rhoose, Vale of Glamorgan
Sir, Martin Barrow (Opinion, May 22) argues that “what is required is a massive transfer of resources into the community. . .”. It is certainly possible that our overly centralised health planning system could demand and implement this. However, our hospitals are full to bursting.
Everywhere else in the developed and developing world I see new hospital facilities being created to meet the increasing expectations of people who are living longer and require healthcare for more years. The “experts” who claim that we can simply transfer resources ignore the facts from almost everywhere else.
We seem to be the only country which has commissioning, but unless we manage expectations we cannot expect our limited GDP spend on health to achieve everything for everyone forever.
Tony Narula, FRCS
London W2
Sir, The average GP has about 2,000 patients on their list, the average practice 8,000. Despite this, most children never need to see a paediatrician, most women never see a gynaecologist most elderly never see a geriatrician and most chronic diseases, such as asthma, chronic lung disease, diabetes are managed entirely by GPs in primary care. A consultation with a GP costs the NHS about as much as a phone call with NHS Direct — we are hardly expensive and overpaid.
The number of consultations a general practice provides has doubled over the past ten years.
More and more work has been moved out of hospitals to us in the community — yet we are supposedly working less and are lazy. There is a recruitment crisis in general practice because hospital consultants earn more and general practice is not an easy life with short hours.
GP bashing will only aggravate this and, as Martin Barrow wrote, what is needed is for more work to be done in primary care and more GPs to do it.
Dr Mona Kooner
London SW18

Those who find themselves defendants in the criminal justice system are quite able to recognise a lawyer whom they can trust
Sir, As a solicitor advocate practising in the London criminal courts I take exception to the Justice Secretary, Chris Grayling, defending his plans to abolish the right of a legally aided defendant to choose their own lawyer on the basis they are “not up to making a selection”, and are not “great connoisseurs of legal skills”, (report, May 20).
I suspect that Mr Grayling would consider it beneath himself to canvass the views of those who find themselves defendants in the criminal justice system, but were he to do so he would find that, whatever their other shortcomings, they are quite able to recognise a lawyer whom they can trust and who will work hard on their behalf.
Such people have been coming to see me and my colleagues for good quality advice and representation for more than 20 years, a personal service that will be lost forever if these reforms are implemented. Will a government supposedly committed to choice and localism now be saying that patients should not be allowed to choose their doctor, or parents their children’s school, because they are not great connoisseurs of medical or teaching skills?
Harry Grayson Shaw
Graham Kersh Solicitors London W1

The risks of accepting that climate change will be slow are so immense that we cannot afford to stop taking immediate action
Sir, Matt Ridley’s contrarian views (Opinion, May 20) have to be set against the weight of mainstream scientific evidence. Granted that no science can ever exclude the “possibility that climate change will be slow and harmless”, the risks of accepting Ridley’s hunches are so immense that we cannot afford to stop taking immediate action and insuring against irreversible longer-term damage. Appealing though it is, we should not allow ourselves to take comfort from his “rational optimist” ideology.
We should also recognise that de-carbonising the economy has other benefits — the substantial health risks and environmental degradations resulting from the use of fossil fuels would be reduced. Further, the UK would also be able to decrease its dependency on energy imports and improve energy security — again a very significant problem.
These other drivers of change have recently gained credence in the US. Meanwhile, this Government, like the last, has accepted carbon reduction targets. Achieving those will not be easy as the debate about wind farms shows. But we do need to show a real resolve to protect the planet for the benefit of future generations and Ridley’s highly selective use of data and his focus on the short term must be firmly rejected.
Professor Ted Cantle
Nottingham
Sir, The climate debate, with all its uncertainties and the hype on both sides, has turned so many people away from taking environmental issues seriously and distracted attention from other, more pressing, problems: the increasing shortage of fresh water needed to grow food; the destruction of natural habitats and loss of biodiversity; the exhaustion of non-renewable natural resources; and the pollution of soil, groundwater, surface water and air with man-made substances and waste.
All of these problems are symptoms of the serious disease affecting our planet — overpopulation combined with overconsumption.
Professor Jane Plant
Imperial College, London

The root cause of closures in the high street can be traced back to the abolition of the Retail Price Maintenance Act
Sir, There would be considerably more boarded-up shops (“Caught in the net: high street closures reach record levels”, May 20) were it not for the influx of nail parlours and restaurants. The root cause of this situation is not the existence of Amazon and other online retailers but can be traced back to the abolition of the Retail Price Maintenance Act which has given a massive advantage to unseen retailers. They are able to offer products at margins considerably smaller than those which can be offered by the traditional retailer.
Indeed, my experience as a would-be local shopper rather than an online spender has often made me, albeit with some reluctance, succumb to the internet — perhaps in good company, and leading to the closure of another “Arkwright’s”.
Jack Lynes
Pinner, Middx

The best people to know how to deal with the practicalities of successful teaching are those in the classrooms
Sir, It was Dr Johnson who offered the simple truth “nobody can be taught faster than he can learn” followed by real examples of the constraints encountered by those doing the instructing. Mr Gove would probably find this a defeatist attitude (Opinion, May 20). I think it serves to remind us that teachers are better placed and equipped to deal with the practicalities of successful teaching than are the idealised processes of his regime.
Keith Robinson
Littlewick Green, Berks

Telegraph:

SIR – Rupert Christiansen (Arts, May 20) says he is increasingly irritated by the assumption that plays and operas have to be put in a modern context for us to understand them.
At last someone is saying in the press what lots of us have been thinking for a number of years. Updating plays and opera often obscures rather than explains an author’s intentions.
As Neil MacGregor makes clear in his recent book Shakespeare’s Restless World, Tudor plays are best understood if we appreciate the views and beliefs of the audiences of those times. I am of the opinion that for a true understanding of plays and opera they should be set in the period denoted in the play or the period in which they were written.
The problem is how to convince theatrical companies of this belief. It took a war of attrition to get opera Surtitles, especially for those written in English, so perhaps this will be a similar battle.
Peter Gray
Hampton, Middlesex

SIR – David Cameron was elected Conservative leader in 2005 by a grass-roots membership dispirited by three consecutive defeats and aware that the party had to modernise or die. The rows about homosexual equality and Europe are similar to those in 2007 over grammar schools, when a significant proportion of activists and MPs placed ideological purity above the pursuit of power.
All the polling evidence from May 2010 supports the claim that the Tories’ failure to achieve an outright win was due to lingering doubts about the party’s appetite and sincerity for change.
For the Conservatives to have any prospect of political survival, let alone victory in 2015, the Prime Minister must not retreat from his courageous attempts to rebrand the party away from reactionary and electorally toxic policy positions in order to attract the support of the many millions of people for whom voting Conservative has become an anathema.
Philip Duly
Haslemere, Surrey
SIR – Can David Cameron explain to us the point of a modern and detoxified Conservative Party that is devoid of members?
Related Articles
Modernising plays obscures authors’ intentions
22 May 2013
Paul Elswood
Bursledon, Hampshire
SIR – By voting for extending the rights and responsibilities of lawful marriage to gay people, and opposing civil partnerships for non-gay couples, traditional Tories will be doing much to affirm marriage itself, and seeing off the dangerous innovation of civil partnership which was never intended to be more than a half-way house. There is no need for an extra category of committed personal relationships.
Rev Richard Haggis
Littlemore, Oxfordshire
SIR – David Cameron’s refusal to apply the same principle of equality to civil partnerships as he purports to apply to marriage demonstrates that his priority is not, in fact, that of equal rights.
His position leads naturally to the surprising conclusion that the intention of the Bill is to nationalise the institution of marriage, thereby rescuing it from the hands of various categories of the lunatic and swivel-eyed, and distribute its goods as the Government sees fit.
Oliver Iliffe
Ogbourne St George, Wiltshire
SIR – At one time homosexuality was a capital offence, then deportation and imprisonment became the sanctions. Over the years it was severely frowned upon, followed by merely not being talked about.
It then became accepted and gradually approved of. It seems that today it is almost fashionable. I’m 74 and hope to be dead before it becomes compulsory.
Donald Lewis
Gifford, East Lothian
SIR – It is interesting to see that the main objection from Conservative constituency chairmen is not the question of a European referendum but gay marriage, even though it is legal in the Netherlands, Spain, France, Portugal, Denmark, Sweden, Norway, Iceland, South Africa, New Zealand and Canada, and in many states in other countries, including the US, Brazil and Mexico.
Henry Page
Newhaven, East Sussex
SIR – On the BBC’s Politics Show, Jacob Rees-Mogg asserted that “marriage is for the churches to define”. I find this wholly objectionable. What message does that send to those of us for whom “churches”, of whatever denomination, are completely irrelevant? After 24 years of marriage, I neither want nor require the approval of a church and I will define my marriage without Mr Rees-Mogg’s guidance.
Throughout history, “churches” have consistently opposed every single advance in lesbian, gay and bisexual rights, and if “churches” had been allowed to prevail, these rights would still be where they were 100 years ago – non-existent.
Stephen Drage
Devizes, Wiltshire
Nazi uniforms
SIR – Regarding your report about people wearing Nazi uniforms at the Haworth 1940s Weekend (May 20), Haworth is a charming West Yorkshire hill village which during the war never saw persons in anything other than Allied uniforms. There is no historical justification for wearing any other uniforms at such an event.
From what I have been told about the decade, I find the whole idea of celebrating the Forties a bit odd.
David Pearson
Haworth, West Yorkshire
SIR – We have always welcomed re-enactors in Axis uniforms, but try to discourage those with death’s head/SS emblems and blatant swastikas that cause offence – hence my notices in the local shops. Those who wear Axis costumes to this event are not neo-Nazi thugs. All that I have spoken to are hobbyists who seek to be as accurate as possible.
Peter H Hill
Haworth 1940s Weekend Press Officer
Haworth, West Yorkshire
Wagner for beginners
SIR – Where to begin with Wagner? (Comment, May 21). I recommend getting a recording of orchestral highlights (George Szell and the Cleveland Orchestra from 1962 is unbeatable). Plunge straight into the Prelude and “Liebestod” from Tristan. It is slow in its build-up (so young people tend to give up before they get to the best bits), but you should find yourself ardent after about six minutes, feeling thwarted at seven and a half minutes and, roughly three minutes before the end of the “Liebestod”, you should find fulfilment!
Ian France
Penrith, Cumberland
Bats and balls
SIR – Your report (May 21) about research at Southampton University into echolocation ability was interesting, but failed to mention the fact that cricket has been played by blind and partially sighted people for more than 25 years. There have been three world cup competitions.
The ball is filled with ball bearings and the resulting sound enables the batsman and fielders to “see” it using their considerable echolocation skills, which they develop by playing. So not only can they see as if they were bats, but they can bat as if they could see.
Rupert Wilson
Shepley, West Yorkshire
Heart health equality
SIR – The British Medical Association was right to say the Government is failing vulnerable children (report, May 17).
Heart disease is the biggest cause of health inequalities across Britain. People from the poorest communities are around three times more likely to die from coronary heart disease (CHD) than those from the most affluent.
At the British Heart Foundation we are working to fight these inequalities. Through our Hearty Lives programme we are partnering with local councils and health authorities to improve the heart health of those most in need.
We’ve already helped more than 60,000 people reduce their chances of developing CHD. But with 3.6 million children living in relative poverty, we must do more.
The Government, local councils and community groups need to invest in initiatives that empower young people and their parents to live more healthy lives. Unless action is taken, we’re a long way from achieving equality.
Simon Gillespie
Chief Executive, British Heart Foundation London NW1
Scottish oil and gas
SIR – There seems to be an assumption among Scottish nationalists that North Sea oil and gas revenues will be theirs upon independence from the UK.
But the international convention on national boundaries states that the land border is extrapolated into the sea. Looking at the map of current drilling and exploration activity in the North Sea, and bearing in mind that the land boundary between England and Scotland is acutely angled in a south-west to north-east direction, it appears that less than half of all the oil and gas fields will be within Scottish territorial waters.
Has anyone done the detailed calculation as to how much Scotland will end up with?
Robin Morello
Horton, Buckinghamshire
Franglais
SIR – I was interested to read of the latest efforts by the French to resist the incursions of the English language into their native tongue (report, May 21).
I wonder what French terms the Académie Française would suggest for use in place of Anglicisms such as bête noire, raison d’être and cul-de-sac?
Steve Howe
Grays, Essex
GPS tags can help those suffering from dementia
SIR – Mr Neil Duncan-Jordan (report, May 1), national officer of the National Pensioners’ Convention, calls the use of GPS tags for elderly people with dementia “inhumane”. I would like to ask him how “inhumane” he considers it to be when people with dementia cannot go outdoors because they might get lost, or they go out and indeed do get lost, and become upset because of it.
In the Netherlands, GPS tags are used increasingly often for people with dementia. The device allows them more independence and puts their relatives’ minds at rest as they know their partner, parent or sibling can be traced.
As a social worker in this country, frequently working with people with dementia and their relatives, I can only encourage the use of these tags.
Annelies Barth
Colchester, Essex
SIR – Round and round we go on the issue of dementia diagnosis (report, May 15).
In 2009 the Labour government’s national dementia strategy was welcomed by all in the sector. At last, there was recognition that dementia was a problem that was not going away. One of the key features of the strategy was the need for early diagnosis and a call for more funds for GP training to help spot the signs.
But nothing has happened in the last four years. How we look after those with dementia needs to be addressed as a matter of urgency. Currently 670,000 people have dementia, and that figure is expected to double in the next 30 years.
Is there really a commitment from the current Government, or will we be no better off in another four years’ time?
Leon Smith
Chief Executive, Nightingale Hammerson
London SW12

Irish Times:
Sir, – No wonder our nation State is in such a perilous position when all the Dáil can do is to debate cheap village political tittle-tattle. Even worse is the amount of headline news time this topic is taking up in the media.  What the people of this country wish our politicians and commentators to concentrate on is jobs, the health-care system, fighting crime, the economy, promoting growth and exports – and even legislation to stop women dying in childbirth.
Two of my three children are working abroad; despite first class degrees from Trinity and Cambridge they are unable to find work here. In the case of my son, one public service department didn’t even do him the courtesy of an acknowledgment to a job application!
I say to all members of the Dáil get on with the real issues that concern the electorate and stop this nonsense. – Yours, etc,
JOHN TURNER,
Kilteragh Road, Dublin 18.
Sir, – The real scandal in this controversy is not the fact that Alan Shatter disclosed that Mick Wallace had been cautioned by a garda. The only one damaged by that revelation is Mr Shatter himself.
The really scary thing is that the Minister knew of it. He says that the information was given to him by the Garda Commissioner. There are three possible explanations for how that information came into the possession of the commissioner. 1. The commissioner is  routinely informed of every conversation any garda in the country has with any citizen. Most unlikely! 2. Before the debate, there was a trawl of all gardaí to see if there was any dirt that could be used against Deputy Wallace. Possible! 3. There is a standing procedure that every Garda contact with a politician is reported to the Commissioner/Minister. Equally possible!
Whichever is the case it calls to mind the Stasi, the Gestapo or the KGB. – Yours, etc,
JOE CUNNANE,
Herbert Road,

Sir, – Our German readers are curious whether reports are true that the Irish Government has made a deal with Apple to the effect the Apple is only paying a two per cent tax on its income and that Apple has been using this non-taxing-regime to escape paying their fair share for using infrastructure in the US and the rest of Europe. Proper taxing of Apple’s billions of income would make EU subsidies for Ireland superfluous it seems. Any idea how to communicate these Irish decisions to German consumers? – Yours, etc,
HERMANN TENHAGEN,
Chief Editor, Finanztest,
Lützowplatz,
Berlin, Germany.
Sir, – With all the furore over the tax avoidance by Apple, I presume that it has an app for that? – Yours, etc,
THOMAS KING,
Solomons Manor,
Letterkenny,

Sir, – John Waters’s article (Opinion, May 17th) on the higher rate of suicide among young men goes to the heart of the problem when he mentions the “dilution of transcendent hope in our culture in recent years”.
Formerly, the Catholic Church played a valuable role in this regard. When a young man was unable to find work, or if his girlfriend rejected him, he felt that this was a “cross” that had a meaning. Now, in the absence of transcendent meaning, suffering is seen as either merely bad luck, or of such devastating importance that it makes life unbearable.
As someone who has found meaning for my own cross in the Catholic Church when I was a young man, I hope that the Church in Ireland reawakens in order to fulfil this vital role. – Yours, etc,
DONAL DEASY,
Granville Avenue,

Sir, – Thanks to Ceire Sadlier and to The Irish Times for publishing her letter on May 13th, we too discovered that we were liable to pay the non principal private residence tax. It seems that The Irish Times Letters page is a more effective means of advertising this tax obligation than the local authorities’ choices so far. – Yours, etc,
THOMAS HUBERT &
MARY TRAYNOR,
Avenue Simon Bolivar,
Paris, France.

Irish Independent:

* The next Catholic Primate, Archbishop Eamon Martin, has controversially stated that TDs who support the Protection of Life During Pregnancy Bill are excommunicating themselves and should be denied Communion because they would be knowingly introducing legislation aiding and abetting abortion.
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The archbishop’s comments add no clarity to the debate and are politicising the Eucharist once again. In my humble opinion, legislators are introducing this legislation because they have an obligation to do so because of a decision that was made by the Supreme Court in 1992.
Their intention is not to aid and abet abortion, as has been alleged by the archbishop – instead their intention is to provide legal clarity for medical practitioners when they are faced with difficult medical decisions about saving life when treating a seriously ill pregnant woman.
I would like to ask the archbishop a question. I also believe the sacrament of Communion is a very sacred one. How does he feel about those senior clerics who knowingly transferred clerical abusers to other parishes, not only resulting in their continued abuse of children but it also allowed them to continue administering the sacrament of Communion?
Does he think that those senior clerics who knowingly took this course of action should be allowed to either administer the sacrament of Communion or present themselves for Communion?
I await his response.
John Cushnahan
Address with editor
SHOW COMPASSION
* There are complex reasons for girls and women to elect for abortion. Attempting to take the old-style authoritarian high ground with subtle threats of excommunication will only damage the Catholic Church. Those days are gone.
Compassion and understanding are the only ways to resolve this problem. In the specific issue of a suicidal girl or woman seeking abortion, it would be impossible not to be moved to empathise. Insisting by proxy that a vulnerable person takes a boat is callous and unjust.
Far from “not being able to regard yourself as a person of faith and support abortion”, as per co-adjutor Archbishop Eamon Martin, I would ask what benefit it is to the faith to have abortion banned by legislation where the heart of the person is ignored?
You come to God, to Christ and to the church through love and not law. But I’m sure that if one woman decides that she will not have an abortion because it would break her heart, that would mean more to our faith than stopping 5,000 abortions from being carried out in Ireland through law.
John O’Connell
Derry
EUROVISION LUNACY
* “The definition of lunacy is doing the same thing over and over again and expecting different results” – Albert Einstein.
Has anybody in RTE considered applying this wisdom to its continuing involvement in Eurovision?
Paul Harrington
Navan, Co Meath
THE SLAVE MENTALITY
* During the queen’s state visit to Ireland, our Taoiseach Enda Kenny praised the contribution that Brendan Bracken made to the British war effort by assisting Winston Churchill in Downing Street.
It must be remembered that it was the same Winston Churchill, who as secretary of war, introduced the Black and Tans into Ireland in 1920, a move that was broadly opposed and criticised by King George V, the then British head of state.
The Black and Tans were notorious and Churchill was the key man behind their operations in Ireland. If we are to achieve freedom, then we must think like free people, liberal and conservative in our own right, conservative to the extent that we must preserve what is ours and ours alone and eschew that which is not.
We must learn to think for ourselves and develop a sense of identity with our native land that is inherently Irish and not something which is imposed upon us by a foreign master.
P J O’Reilly
London
LACK OF EMPATHY
* The language used by Environment Minister Phil Hogan is revealing when he refers to 24pc of the electorate as “rebels” and warns of punishments for those who do not comply with the property tax.
This threatening stance is not acceptable when people are at their wits’ end as to how to pay bills, taxes, mortgages and now a property tax.
We have elected a Government with little empathy for those worst hit. Some people should not be given power and Mr Hogan is one of them.
Caitriona McClean
Weston Ave, Lucan, Co Dublin
GROOMING THE YOUNG
* In her recent letter, Kathryn D’Arcy of the Alcohol Beverage Federation of Ireland (ABFI) states that the suggestion that the drinks industry targets young drinkers is completely unfounded. However, a recent independent review of alcohol advertising across Europe found that children who watch TV stations such as ITV and Channel 4 see more alcohol adverts than do adults.
In view of the research and money behind marketing campaigns, this cannot be an accident. That same review found that all of the examined alcohol advertisements on those stations contained elements which are known to be attractive to children.
In light of this latest evidence, the ‘British Medical Journal’ was prompted to publish an editorial deploring the fact that we facilitate the efforts of the drinks industry to ‘groom’ children to become the next generation of unhealthy drinkers.
In Ireland, our ridiculous self-regulation guidelines on alcohol advertising allow the drinks industry to target advertising at children by bizarrely allowing them to advertise during programmes which are preferentially watched by children.
This is working. Research from 2006 by the Office of Tobacco Control indicated that children were spending over €140m buying alcohol each year. These children have become young adults in the intervening years. Between the ages of 20 and 25 years, the average young Irish person consumes their own bodyweight in pure alcohol.
The National Substance Misuse Strategy Group has determined that our society should no longer facilitate this activity.
Dr Bobby Smyth MRCPsych
Department of Public Health and Primary Care, Trinity College, Dublin
SUICIDAL FATHERS
* If the male is suicidal because the mother of their unborn wants an abortion, is that in the proposed legislation?
K Nolan
Caldragh, Carrick-on-Shannon, Co Leitrim
GAA VIOLENCE
* I came across a Facebook page yesterday that glorifies fights in GAA matches. Recent articles in your paper have concerned the pandemic of violence within the GAA. The fact that nearly 30,000 people had ‘liked’ the page in just two days only goes to show how on the money those articles were. Frightening stuff.
Trevor Dunne
Tralee, Co Kerry
BETTER THAN THE ZOO
* Why does the Alan Shatter-Mick Wallace contretemps remind me of dialogue between a dead sheep and an ill-natured chihuahua?
P J Kray
Galway

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