Consultant

16 July 2013 Consultant

Some Navy lark today too ill to go all the way around the park round the park but I manage half way round nice to hear Pertwee again.
Warmer today manage to get to hospital Mary saw her Consultant, some more tests then treatment.
We watch Barnicle Bill its not bad,
No Scrabble today

Obituary:

Rosalind Hudson
Rosalind Hudson, who has died aged 86, worked at Bletchley Park during the Second World War and later constructed perfect scale models of Highgrove House, the Dulwich Picture Gallery and of buildings in Bath, Wiltshire, London and Edinburgh.

Rosalind Hudson 
5:32PM BST 14 Jul 2013
Her lifelong interest in architecture had its roots in Liverpool, where her maternal grandfather, Walter Aubrey Thomas, had designed the Liver Building (begun in 1908), whose distinctive silhouette was to become synonymous with the city.
Born in the Wirral on July 31 1926, Rosalind Audrey Clare Latham attended the Liverpool School of Art, where the illustrator Norman Thelwell, best known for his humorous drawings of ponies, was a fellow student.
She abandoned her studies to join the WRNS, and after training was sent to Bletchley Park, where she worked in Hut 8, in which the German naval Enigma ciphers were broken by a team led by Alan Turing. Her natural modesty meant that she never sought the limelight about her role in this vital war work, and she would never discuss what she did.
In 1945, when Bletchley was running down, she was sent to the south coast to help with work at the naval dockyards. It was there that she met a dashing young Marine, Richard Hudson, who was on embarkation leave, about to be posted abroad for two years. One day Rosalind, still in her WRNS uniform, was setting off for home from Portsmouth railway station, and was waving him goodbye from the window of her carriage, when he called out: “Will you marry me?” She just had time to call out “Yes!” before her train pulled out of sight.
After the war Rosalind Latham trained as a florist under Constance Spry, arranging flowers at Claridge’s and the Savoy — and when she and Richard Hudson married in 1949, as a thank-you for her floristry work the Savoy made her a wedding-night present of a suite overlooking the Thames.
Rosalind Hudson also provided flowers for the home of Somerset Maugham and his wife, the interior designer Syrie Maugham. It was these visits to the Maughams’ house, where the interior was decorated in Syrie’s then radical signature white, which influenced Rosalind’s own taste: her own homes, beautifully arranged, were painted white, always with touches of green.
She also played the piano to concert standard and was a gifted watercolourist specialising in pictures of flowers and foliage.
But it was in her architectural models that her gifts found their strongest expression. Georgian architecture held particular appeal for her, and her fine models of buildings in Bath can be seen in the Building of Bath Collection and the Pump Room. Visitors to Sir John Soane’s Dulwich Picture Gallery are met by her model of the building, which stands in the foyer.
When the Prince of Wales married Lady Diana Spencer, Rosalind made a model of Highgrove House as a wedding present; later, when the Prince wanted to add a new porch, she was commissioned by him to alter the model. She made models of other private houses, accepting payment only under duress.
Rosalind Hudson lived lightly, a great proponent of the make-do-and-mend ethos of her wartime youth. She could upholster her own furniture, make her own curtains and smock dresses for her daughters, and paint her own rooms. She was a wizard at anagrams, puzzles and word-games.
A diminutive but always energetic figure, she was often to be found perched at the top of a precarious stepladder, replacing a light bulb or straightening a pelmet. She enjoyed birds and the natural world around the farm near Bath where she brought up her family.
She is survived by her husband and by their three sons and two daughters.
Rosalind Hudson, born July 31 1926, died July 7 2013

Guardian:
Tomorrow it will be 10 years since the suspicious death of the biological weapons scientist, Dr David Kelly. His death is a matter of continuing public and professional concern. Ten years after the Hillsborough disaster, the truth was still deeply concealed. Only recently, with the publication of the independent panel report, has the extent of the cover-up become recognised. Ten years after Dr Kelly’s death the truth is similarly concealed. As doctors, we have multiple serious concerns about the medical, forensic and other evidence supporting the official story that Dr Kelly committed suicide. We believe that there are serious deficiencies in the investigation of Dr Kelly’s death by Thames Valley police. In the interests of justice, both an inquest into Dr Kelly’s death and an Independent Police Complaints Commission investigation into what we consider to be a deficient and dishonest investigation by Thames Valley Police are required.
Dr Andrew Watt, Dr Stephen Frost, Dr David Halpin, Dr Christopher Burns-Cox

In the course of an articulate and wide-ranging reading of my book on Machiavelli, The Garments of Court and Power (Review, 13 July), Colin Burrow has come away with a number of impressions I only wish I could have foreseen and managed to avoid creating. Of course we differ as to whether Machiavelli’s use of the term lo stato does in fact, in the crucial passages I cite, mean something like the “princely state” I have described in earlier works – a neoclassical state modelled on republican lines and contrasted with feudalism and the role of the universal church. Harvey Mansfield and Francis Fukuyama appear to agree with Mr Burrow and apparently I haven’t persuaded him.
And too we disagree about what constitutes a “moralist”. Burrow very much wants to deny this description to Machiavelli; Burrow thinks a moralist must be someone who holds “that ethical principles override any political consideration” and he says that such a person would not be persuaded, for example, that waterboarding could ever be justified since to believe torture is wrong means that you think it is wrong whatever it achieves. I don’t own the word “moralist”, but I do maintain that Machiavelli advocated in some detail a moral framework that differentiated a person acting for himself alone and one acting through public office bestowed by the people of a republic. And I do not see why Machiavelli’s insistence on this distinction denies him the right to say that he has a consistent and keenly felt moral stance. The policeman who threatened a prisoner caught collecting a ransom note in order to find out the whereabouts of an abducted child may be wrong to have done so; but it is a little high-handed to say that he cannot have a moral reason for having done so.
But what I find most irksome about the description of my book, as I was doubtless intended to, is the claim that I “suggest” that “we need people like [myself] to encourage leaders to do the unspeakable”. Such innuendo is beneath a scholar of Burrow’s stature. For those persons interested in my views on the lawfulness of torture, and the importance of the state scrupulously and transparently following the law, these subjects are treated extensively in Terror and Consent, published five years ago by Penguin.
Professor Philip Bobbitt
Wechsler professor of jurisprudence, Columbia University, New York

As the battle to allocate blame develops (Fraud office called in after G4S ‘overcharges’ for tagging, 12 July), there are some questions to ask. First, what about the role of the auditors, both internal and external? Big organisations, whether in the private, public or charitable sectors usually have independent internal audit before getting anywhere near the external auditors. Why didn’t the “over-billing” get picked up during these stages? After all the recent financial debacles, isn’t it time the standard of audit across all sectors was properly scrutinised?
Additionally, given the huge increase in the amount of outsourcing, shouldn’t the Freedom of Information Act be applied to the private sector undertaking work for government? It is wrong that the big outsourcing companies can conduct their business behind a veil of secrecy, in the name of commercial confidentiality. It’s our money they are spending. If we are to have outsourcing, shouldn’t the politicians who ran the show over three decades acknowledge their culpability in turning the civil service into a commissioning and contract-letting organisation without giving it the tools and resources to do it properly?
But lastly, shouldn’t we think again about whether we really want outsourcing at all?
Gillian Dalley
London
• It is really encouraging that the Guardian is continuing to highlight the risks to the criminal justice system that the government’s close links to private contractors are creating. The Probation Service faces the prospect of a massive reorganisation, with 70% of the cases being transferred to newly set-up private-sector organisations. This model is untested and the changes are being rushed through to satisfy the political agenda of the justice minister, who appears to be ignoring the risks highlighted by his own advisers.
The situation with respect to G4S and Serco now raises the interesting prospect of the directors these companies being on probation supervision orders rather than supervising the “Newco” probation companies. The Surrey and Sussex branch of Napo, the professional association and trade union representing family court and probation staff, made a short film to illustrate our concerns about these proposed changes (search on YouTube for “Grayling sinks probation”).
Name and address supplied
• One of the fundamental reasons for both the privatisation of nationalised industries and for contacting out public service tasks such as tagging offenders is that the private sector can borrow money commercially, unlike the Treasury. Though an investigation by the Serious Fraud Office into some outsourcing companies is warranted, an inquiry by the public accounts committee into the Treasury rules on public-sector borrowing is also needed. It’s strange that German and French nationalised utilities running their railways, gas and electricity can borrow capital commercially, enabling them to invest in acquiring British rail contracts, as well as acquiring our former nationalised gas and electricity concerns. If our Treasury rules preventing state-owned companies from borrowing are so sensible, how come these have not been adopted by  our partners in the EU. This is a proper subject for a PAC hearing.
Jeremy Ross
Ashtead, Surrey

David Nicholson, the NHS chief executive, has raised alarming questions about how the NHS can be paid for (NHS chief: cuts alone will mean more Staffords, 11 July). Throughout a working lifetime as a GP, I have carefully watched many changes. I now have a pragmatic but retro-radical suggestion: we should abolish the internal market and thus such subordinate institutions and devices as the purchaser-provider split, autarkic and competing trusts, payment by results and commissioning. All of these may be well intended but collectively are a failing experiment to apply commerce and monetarism to complex welfare.
The human and economic costs of this defederalised system are very high. As fragmentation and boundaries increase, so do procedural, bureaucratic and financial complexity and delay. Competition, or its threat, decreases professional synergy and replaces it with expensively expedient tactics and presentations: glossy brochures, specious statistics, mistrustful feints, “gaming” the systems and being guided more by technical legality than humanistic ethos. I have hundreds of examples, but rarely (if ever) do I discern clear benefits of defederalisation.
Here are two commonplace and recent examples. First: my local GPs have cumulatively invested hundreds of hours tendering competitive plans for an out-of-hours centre. This was a politically prescribed project of no real value; it evaporated without sense or trace. Second: at a mental health centre, I attended a dreary meeting where eight fractiously obedient practitioners discussed for half an hour a patient who none of them had ever met; in particular, whether the referral was procedurally correct. Until recently, this would have been dealt with by a friendly five-minute phone call by an experienced practitioner with good sense and courtesy. That way, time and energy were saved, helpful relationships fostered.
Such losses and follies may seem comically grotesque to an outsider: as an insider, I know the enormity of the consequences, the costs to people as well as budgets. Such is the maturing culture of corporatised and marketised welfare. The old, federal, “socialist” NHS did not have these problems. Yes, it had others, but I think they were more honest and more soluble.
Dr David Zigmond
London
• A&E departments may well be unprepared for this winter, but need not be so if the NHS were financed and run sensibly. The budgets for hospital care have moved into the hands of bodies of mostly GPs. There is nothing wrong with that provided that GPs take responsibility for their patients. Research has shown that in practices where patients cannot get an appointment within 24 hours, A&E is the fallback position for 38%; where practices offer a more rapid appointment, that figure falls to 1%.
Surely the clinical commissioning groups should charge GPs for A&E appointments and pass that on to the hospital. A&E would then be able to concentrate on what it is designed to do: serious and immediate care.
Dr Stephen Seddon
Market Drayton, Shropshire
• I note that in your report anticipating the publication of the Keogh Report (NHS officials fear new attack, 15 July) you repeat the canard ” … at Stafford Hospital, where between 400 and 1,200 are believed to have died …”  I am weary of reading this allegation in the red tops and Tory press, but I draw the line at seeing it in the Guardian. Unfortunately, the allegations have been reprinted so often, without any dispute, that they have been assumed to be the truth. Could we for once and for all clearly state that this simply did not happen?
The full story is a long and complex one, far too labyrinthine to go through in depth here, but the key facts are: Robert Francis refused to include these figures in his report because they were unreliable and likely to arouse public anxiety. How right he was: they derive from the flawed figures devised by Brian Jarman – a ratio measure known to be limited even when correctly applied. In Stafford, the measure was not correctly applied or coded. Computer buffs know the acronym Gigo: garbage in, garbage out. Never more true than here.
In 2009, Dr Mike Laker was asked to conduct an independent review into the detailed case notes of every contentious death at Mid Staffs during the period in question. He and his independent team of expert clinicians examined a self-selected group (one would think the 60 who asked to be reviewed were the ones with most cause for concern) and after a 5-6 month review of each case, found “perhaps one such (excess) death”.
For those who would like to read and digest a fuller version, the issue has been brilliantly analysed by Steve Walker here. Why are these figures so widely repeated? It is high time that the true Stafford story was told.
Gail Gregory
Support Stafford Hospital
• As a kidney donor recovering from surgery on 1 July,  I am compelled to counter the criticism of high death rates at 14 NHS Trusts. It would be a disaster if adverse publicity affects the willingness of donors to give. The need for kidney donors outstrips demand by at least one to four. About 7,000 people in the UK are on the waiting list for a transplant, according to the Department of Health, and 300 will die this year as they wait a suitable donor. Negative media should not deter those considering donating. The level of care and attention I received was exemplary.
Ken Evans
Matlock, Derbyshire
• The problem with A&E is that it is all we have. All hospitals should have a cuts and bruises facility where you could go as a triage point to be treated/reassured, then either directed back to your GP or on to the hospital. You’d need a nurse and a doctor, a thermometer, blood pressure monitor and a bag of dressings. We don’t need a few large facilities treating people with heart attacks alongside people with bee-stings.
Rob O’Brien
Farnham, Surrey

Susanna Rustin is right to highlight the strength of independents on local councils and to connect it with the growing strength of the Green party (and of Ukip) in local government as well at Brussels and Westminster (Behind the monkey suit, 15 July). But it is worth adding a couple of facts about the Green-independent nexus. Green councillors are in the independent group of the Local Government Association. We are natural allies. Furthermore, Greens, uniquely among major contemporary political parties, don’t whip. In a certain important sense, we are independents.
Rupert Read
Former Green councillor, Norwich
• These novelists – make up stories from start to finish and then pretend to be somebody else (JK Rowling adopts pen name, 15 July).
John Bailey
St Albans, Hertfordshire
•  The Cuckoo’s Calling proves that a talented author doesn’t need a famous name to succeed. But having the services of JK Rowling’s literary agent, editor and publisher may help.
John Cranston
Norwich
• I read that Queen Victoria’s last PM (Final telegram, 11 July) sent a memorable telegram before catching the train to stay with his son in Dorset: “Cranborne, Cranborne. Arriving 4.30 Salisbury. Salisbury.” (I’m not sure of the exact time.) Can anyone verify?
George Baugh
Shrewsbury
• As a primary school head, my father prepared for decimalisation by ordering centimetre rulers (Letters, 9 July.) They had to be ordered in bundles, a dozen in each.
Hilary Grime
Oxford
•  The introduction of decimal currency does not obviate the need for the 12 times table so long as there are 12 months in a year, 24 hours in a day and an hour divided into 12 five-minute segments. Musicians gauge tempo according to the number of beats per minute and the figures given by composers and/or editors are usually multiples of 12, eg, crotchet=96.
Gary Carpenter
West Kirby, Merseyside

Independent:
Times:

‘Legislation and government are serious matters, but their very seriousness requires that those who bear the burden have a safety valve’
Sir, I do not agree with John Cullen (letter, July 13) that the “verbal duel” of Prime Minister’s Questions (PMQs) should be replaced by reasoned debate.
I’m not naive enough to think the public slanging isn’t largely scripted or that it shapes policy and legislation of the day, but I do know that it’s fun, it subjects politicians to much needed public challenge, all the while addressing the issues of the week for a slot on the news.
Reasoned debates are held throughout the week by informed, well-meaning MPs, but they are dull to watch. The Speaker chastises MPs for their behaviour, claiming the public do not want this noise and energy — I think a lot of people do.
Michael Dodds
Manchester
Sir, The slanging and haranguing at PMQs may not be edifying for non-politicians, but it is clearly irresistible to MPs themselves, since it is almost the only occasion when the chamber of the Commons is full. Devotees of the BBC Parliament channel will know that most of the time during Commons debates the chamber is almost empty.
Civilised discussion is desirable, but for that one looks to the House of Lords. Those not seeking the popular vote or ministerial approval do not have to bawl to make their arguments heard.
David Wilson
Bridell, Pembrokeshire
Sir, May I enter a defence for the often bestial and boorish conduct of the House of Commons at PMQs? The shouting and name-calling is a sturdy buttress to genuine democracy.
Legislation and government are serious matters, but their very seriousness requires that those who bear the burden have a safety valve. An occupational hazard for politicians is to think they are indispensable: power is notoriously sticky. The likes of Dennis Skinner, Julian Critchley and Austin Mitchell have done more than most to keep the House of Commons healthily self-critical. There is more to fight for in a democracy than mere decorum; even bawdy rowdiness has a vital role.
Stephen Pix
Woodstock, Oxon
Sir, While agreeing with my former Foreign Office colleague Sir Leslie Fielding that bold constitutional reform is sorely needed (letter, July 12), I suggest that our present system is not only insufficiently “democratic”, it is disgraced by a widespread cultural sickness: a nearly pathological unwillingness to admit to making a mistake, let alone committing a crime. Denial is the prime response of most politicians, many bankers and NHS bodies, most corporations and trade associations and many unions.
This sickness seems at least partly to derive from an automatic contempt for the “general public”. We are seen as unforgiving slow coaches, incapable of judgment as opposed to prejudice. Yet most of us recognise that we get some things wrong and that both forgiveness and learning are possible.
The vox pop is at least as sensible, and less predictably ideological as what is shouted in the Commons or the hustings. Perhaps the oft-lamented popular indifference to argy-bargy politics is due to a gradually increasing appetite for serious long-term remedy — like responding seriously to climate change and destabilising Third World poverty.
Ronald Higgins
Vowchurch, Herefordshire

The government’s proposed changes to the Anti-social Behaviour, Crime and Policing Bill are supposed to be reasonable, proportionate and effective
Sir, Proposed changes to the Anti-social Behaviour, Crime and Policing Bill will define anti-social behaviour as “conduct capable of causing nuisance and annoyance”. This is a real threat to the quality of life for children in England and Wales. The new injunction, enforceable from age 10, will require significantly less proof to enforce than with ASBOs, yet is be punishable with imprisonment if broken. The Association of Police Officers, which has suggested that the new threshold is too subjective and could unnecessarily criminalise children for simply being children, shares our concern.
This legislation directly contradicts the UN call to support children’s right to play, and rather than tackling the root issue of anti-social behaviour, it will merely serve as another barrier stopping children from playing outdoors with their friends in the street, the park or other public spaces, further jeopardising the physical and mental health of children.
We urge government to rethink its proposals. Efforts to genuinely tackle anti-social behaviour must be reasonable, proportionate and effective. These are not.
Cath Prisk, Play England; Mike Greenaway, Play Wales; Dr Hilary Emery, National Children’s Bureau; Puja Darbari, Barnardos; Sue Armstrong-Brown, RSPB; Sir Tim Smit, Eden Project; Wendy Ellyatt, Save Childhood Movement; Lesli Godfrey, SkillsActive; Julie Hathaway, KIDS; Wendy Russell, University of Gloucestershire; Tony Armstrong, Living Streets; Jason Torrance, Sustrans; Michael Hoenigmann, Association of Play Industries; Professor Perry Else, Sheffield Hallam University, Faculty of Development and Society; Graham Duxbury, Groundwork; Mary Crowley, International Federation for Parenting Education; Fiona Phur, The Regional Youth Work Unit; Alice Ferguson, Playing Out; Eugene Minogue, Parkour UK; Christine Andrews, RePlay (SE Play Association); Mark Gladwin, Activ8 Learning; Susan Moores, Plymouth Play Association; Richard Mckie, Cornwall Youth Work Partnership; Anita Grant, Islington Play Association; Sarah Grand, Lambeth Play Association; Sue Waite, Plymouth University; Ben Ward, World Jungle; Martin Gillett, Oxfordshire Play Association; Jane Acton, Nature Workshops; Jeffrey Hill, Children’s Scrapstore Bristol; Pip Levett, Play Gloucestershire; Tanny Stobart, Play Torbay; Nicola Butler, Hackney Play Association; Toby Blume, Design Council built environment expert; Simon Bazley, NEW Play; Grant Lambie, Free Play; Deborah Cowley, Action for Prisoners’ Families; Arthur Battram, Plexity Neil Coleman, independent play consultant; Katie Hanchard-Goodwin, Inclusive Play, Lead, Bristol Playbus; Simon Rix, Meriden Adventure Playground; Beckey Colley, Birmingham PlayCare Network; Chris McIver, Youth/Sport/Play & Targeted Youth Support Services, Bolton Council; Leo Murray, Monkey-Do CIC; Karen Limbrick, Ground Designs; Dr Ute Navidi, International Play Association; Leigh-Anne Stradeski, Eureka! The National Children’s Museum; Bernard Spiegal, PLAYLINK; David Bond, Green Lions; Andy Grout, Milton Keynes Play Association; Paul Glaze, Council for Wales of Voluntary Youth Services; Dr Gareth Stratton, Professor of Paediatric Exercise Sciences, Director of Applied Sports Technology Exercise and Medicine Research Centre (A-STEM), Swansea University; Dr Ute Navidi, Hillingdon Play Association; Meynell Walter, Meynell Games Group

A lack of familiarity with the building blocks of maths such as fractions, tables and mental arithmetic can lead to a loss of confidence
Sir, I was delighted to read that our children will learn their tables and that fractions will be taught at a much earlier age (“Children to learn rhyme and reason”, July 8).
After a career in industry I returned four years ago to mathematics, which I now tutor privately, mainly to A-level pupils. I have found that often their lack of familiarity with the building blocks of mathematics — fractions, tables, mental arithmetic — has made them lose confidence in their otherwise excellent ability. Once these obstacles have been overcome, their mathematic prowess visibly flourishes.
While we’re on the subject, maths exams have certainly become easier over the past ten years. Cambridge and Warwick universities now use Step exams to select the best students for their maths courses, not being able to rely on the current banal AS and A2 exams. The Step exams challenge mathematical ability, rather than just knowledge of the facts. A-level exams need to cause those taking them to think, not just remember.
Ben Karp
Kingston upon Thames

There have been Criminal Procedure Rules in place since 2005, and they have been welcomed and stuck to by lawyers on both sides of the fence
Sir, Lord Falconer of Thoroton (July 11) proposes the creation of Criminal Procedure Rules to ensure more robust case management in the criminal courts. I am pleased to tell him that there have been Criminal Procedure Rules in place since 2005. The committee which drafted them had been created by the Criminal Justice Act 2003 and was chaired by successive Lord Chief Justices. The implementation of the rules has made an immense difference to the efficiency of the courts and have been embraced and adhered to by lawyers for both prosecution and defence.
Derek French
Member of the Criminal Procedure Committee 2004-10

There is a claim to be made that Christianity arrived here via a young couple, one Roman, one Welsh, who had met St Paul
Sir, Further to your report on the Lindisfarne Gospels (“Dazzling pages straight from history”, July 6) and the letter from Dr Dickson (July 10) about the start of British Christianity, the Roman writer Martial stated that a young Roman senator, Pudens, married a British princess. She was the daughter of Caractacus from South Wales who had been taken to Rome as a hostage after her father’s defeat, and at Emperor Claudius’s insistence she was renamed Claudia.
In 1723 a marble slab was unearthed at Colchester bearing the names of Pudens and Claudia and my source of information which is more than 100 years old, says that at that time the stone had been moved to Goodwood House — is it still there, I wonder.
Interestingly, Pudens and Claudia are mentioned in the second letter Paul wrote from prison to Timothy, as they visited him there.
So there are some grounds for claiming that Christianity came to these islands from a Roman camp at Colchester by a young Christian couple who had met St Paul and that from there the message was taken to her father’s kingdom in South Wales.
Elizabeth Lockwood
Haslemere, Surrey

Telegraph:

SIR – I have cycled past Alexander Fleming House at the Elephant and Castle for years, and Stephen Bayley is right – it is a fine building which grows in stature and presence compared with its neighbours (“One day, even Prince Charles will admire this”, Features, July 11).
Ernö Goldfinger, its designer, included a strikingly original cinema at the rear, reflecting that the site previously housed the vast Trocadero. I remember it had a wonderfully uncluttered, spacious auditorium, like a concert hall, with a bold, free-standing screen and perfect sight lines.
Sadly, within a year of Goldfinger’s death in 1987, in a brazen act of cultural vandalism by the developers Imry, it was bulldozed – the day before it was due to be listed by English Heritage.
Simon Keyes
Kingsbridge, Devon

SIR – Once again the bureaucrats in the NHS have interfered, and in so doing, will deprive many people of a more dignified and comfortable death (“Care pathway to be axed”, report, July 13).
My mother was put on the Liverpool Care Pathway after consultation with the family. It meant that she was not fed through a tube or needlessly kept alive.
I am eternally grateful to the clinicians who devised this pathway and implemented it in my mother’s case. I had hoped the same would be available to me when my time comes.
Sadly, because people have been paid to misuse the system and have taken short-cuts, we will all suffer. Why do we struggle so much against death, which is inevitable, and yet not offer a quality of life to those we artificially keep alive?
Let ethical clinicians run the NHS, fire the costly bureaucrats, and give us the service we pay for.
Related Articles
The striking design of Alexander Fleming House
15 Jul 2013
David R Lewis
Purley, Surrey
SIR – While I have experienced the less than useless consultations and care doled out by the NHS, I must counter your report on the lack of dignity in hospital end-of-life care (July 12).
My late mother (86) suffered a major stroke this June and was taken to the stroke unit at Gloucester Royal Hospital. She had a “living will”.
The care and attention that she received was second to none. All her wishes were adhered to by the staff. She died in the stroke unit 10 days later with a huge amount of dignity, all of which I witnessed.
So the NHS can get it right.
Philip Tisdall
Cheltenham, Gloucestershire
SIR – We agree with Dr Chai Patel’s point that too many people currently die in a hospital environment (“Care home boss: let people choose how to die”, report, July 9). Local hospices play a key role in meeting the personal preferences of people facing the end of life. The majority of care they provide is at home or in the community, where most people wish to be cared for before they die.
Many hospices work in partnership with care homes, for example by training and supporting staff to care for residents approaching the end of life.
Evidence shows that such partnerships help support residents’ choices, for instance through advance care plans, as well as boosting staff confidence.
It also highlights the need for our society to be more open in talking about people’s wishes and preferences at the end of life.
Jonathan Ellis
Director of Public Policy & Parliamentary Affairs, Help the Hospices
London WC1
SIR – The NHS was created to cure people, not kill them. A personalised treatment plan is no solution – there would always be a doubt that the patient had agreed.
Brian Gilbert
Hampton, Middlesex
The case for HS2
SIR – It is clear that the case for HS2 is disintegrating rapidly. It would be a great mistake for the Coalition Government to pursue a project that even Lord Mandelson has admitted was never costed properly from the start.
While the estimated costs are spiralling, there is little explanation of the alleged employment that will be created as a result of the project, and almost no consideration of the thousands of jobs and businesses that will be destroyed instead. The many small enterprises in Camden and Primrose Hill, for example, will not be able to survive 10 or more years of blight.
Nor has the Government properly considered householders’ and business owners’ cases for compensation. The judicial review into HS2 found the Government’s original proposals for compensation to be so unfair as to be unlawful; andso the compensation consultation must now begin again. This will surely add hundreds of millions more to the overall cost of the project.
There are many flaws in the proposals for HS2. The Government should go back to the drawing board and consider the options for improving the existing rail network, providing cheaper, less destructive outcomes that can be realised sooner rather than later.
Cllr Jonny Bucknell (Con)
Belsize Ward (Camden)
Cllr Claire-Louise Leyland (Con)
Belsize Ward (Camden)
Katherine Sykes (Con)
Ward Chairman, Camden Town with Primrose Hill Ward
SIR – Geoffrey Simms (Letters, July 9) quotes capacity approaching 100 per cent at Paddington and 80 per cent at Liverpool Street. That is precisely why we have the building of the biggest infrastructure project in Europe – Crossrail.
Crossrail is costing about £17 billion and will relieve capacity at those termini. By 2025, Euston will be approaching similar levels and that is one of the reasons why HS2 is needed.
He also suggests that people won’t pay 30 per cent more in fares. The proof of that pudding is already in the eating of fare levels on European high-speed routes and Eurostar.
Peter Owen
Claygate, Surrey
Brighter later
SIR – The Met Office has not predicted that wet summers might last for a decade or more (report, June 18).
A science workshop held at the Met Office HQ in Exeter discussed research from the University of Reading. This research suggested that the Atlantic Multidecadal Oscillation, which may last for 10-20 years, could lead to a higher frequency of wetter than average summers before switching to its opposite phase.
That does not mean every summer will be a washout for the next decade, and shouldn’t be taken as a forecast for what we will see in the weeks or years to come.
Dee Cotgrove
Executive Head of Media and Communications, Met Office
Exeter, Devon
Close as two coats
SIR – Winston Churchill and Adolf Hitler may have both enjoyed painting (Letters, July 12), but they had little in common as painters. According to Franz Liebkind, played by Kenneth Mars in Mel Brooks’s 1968 film The Producers: “Churchill voss a rotten painter, rotten. Hitler, now zere voss a painter for you. Could paint an entire apartment, two coats, one afternoon.”
John Price
Stoke-on-Trent, Staffordshire
Marking the Great War
SIR – We are just 55 weeks away from August 4 2014, the 100th anniversary of the start of the First World War. Much effort has been made to plan for the centenary. In truth, no one knows what we are exactly trying to commemorate. A victory, or a national tragedy? A long fought-over peace or a failed peace that precipitated an even greater conflagration 20 years later? Some of the finest poetry, prose and art of the last century, or a lost generation of creative artists and intellectuals?
With this degree of ambiguity, I propose that the best response to mark the centenary would be a two-minute silence at midday on August 4 next year. This should be observed by the whole nation, and indeed the Commonwealth, as a memorial to the 750,000 British soldiers and 150,000 from the Commonwealth who died fighting, and far greater numbers wounded in body and mind.
Silence in the face of such unimaginable suffering is the most appropriate response.
Dr Anthony Seldon
Master, Wellington College
Crowthorne, Berkshire
Country matters
SIR – The Campaign to Protect Rural England (CPRE) wants to protect the precious English countryside (Letters, July 13), yet at the same time states that we urgently need more affordable homes.
The 2011 census gave the population of England and Wales as 56.1 million, an increase of 7.1 per cent from 2001. The Office for National Statistics says that, on current trends, the increase from 2011 to 2021 will be 4.5 million. The additional housing to meet population growth of over 1,000 extra people every day is only part of the picture. We will need corresponding growth in energy and power supplies, schools, hospitals, transport, shops, etc.
If rising population is accepted as an unalterable given, the countryside is doomed. The CPRE needs to work in collaboration with organisations such as Population Matters in order to achieve a sustainable future for the countryside.
Peter Graystone
Newcastle, Staffordshire
Smoke and mirrors
SIR – I heard on the radio that the Government had announced its intention to shelve unbranded cigarette packaging.
Does this mean that it will or will not be found on the shelves from now on?
Kenneth Wood
Exeter, Devon
Why do firms insist on mobile phone numbers?
SIR – I too have had problems with firms insisting on a mobile phone number when attempting to order online (Letters, July 13). I have a mobile phone but live in an area with a poor, or non-existent, signal.
I did get away with entering 12345…once, but the next time, with a different firm, I had to enter a valid number. By the time I received a signal and details of the delivery, I had already received my item.
What is the problem firms have in replying by email or letter, or if they wish to speak, by using the old-fashioned telephone?
David Bryett
Milford-on-Sea, Hampshire
SIR – I have an answer to the problem of having to provide mobile phone numbers on websites.
Fill the offending window with eleven zeros, thus – 00000000000.
Ken Beaumont
Barnet, Hertfordshire
SIR – I have had a lot of calls to a Mr Jones, as someone has used my number as their imaginary mobile number.
I myself also use an imaginary name (Wilson) and number when a website asks for, or insists on, one.
Leslie Watson
Swansea, Glamorgan

Irish Times:

Sir, – The Irish Times is to be congratulated for again drawing attention to the opportunities and challenges of mental healthcare (“After the asylum”, Weekend Review, July 13th, and News Agenda, July 15th).
Last month, the inspector of mental health services highlighted both examples of “good governance” and areas for improvement, especially in relation to human rights (“Mental health services ‘stagnant’ and in danger of slipping backwards”, Home News, June 13th). The inspector noted that “a human rights approach to practice requires education in human rights theory, a change of philosophical focus and a commitment to maintain beneficial change”.
This commitment needs to extend well beyond mental health services.
Mental health is closely related to social arrangements. Individuals from lower socio-economic groups develop mental illness earlier in life and have longer durations of untreated illness. The mentally-ill are at increased risk of homelessness and under-employment. They are more likely than those without mental illness to be arrested in similar circumstances and remand is more likely even when lesser offending is associated with mental illness.
The adverse effects of these economic and societal factors, along with the stigma of mental illness, constitute a form of “structural violence” which amplifies the effects of mental illness in the lives of sufferers. As a result, many individuals with mental illness are all too often systematically excluded from full participation in civic and social life, constrained to live lives shaped by stigma, isolation and denial of rights.
The past decade has, however, seen substantial reform in Ireland. The Mental Health Act 2001 resulted in the removal of indefinite detention orders, new involuntary admission procedures, independent reviews of detention, free legal representation, independent psychiatric opinions, and establishment of the Mental Health Commission to oversee standards of care and protect patients’ interests.
Notwithstanding the challenges facing Ireland, there are continuing signs of progress. The Mental Health Act 2001 is being revised. Legislation for supported decision-making is being developed. Mental health service users, families, clinical staff and health service managers are working very well together to provide the best services possible. There are myriad examples of progressive, collaborative initiatives taking root in hundreds of communities and mental health services around the country.
These reforms require broad societal endorsement if they are to realise their full potential.
This matters to everyone. One in four individuals will develop mental illness at some point in their lives.
Deeply and urgently, this matters. – Yours, etc,
BRENDAN KELLY,
MD, PhD, FRCPsych,
Sir, – When the commitment was made to implement the X case judgment, it was always clear that the resultant legislation, while vital, would be highly restrictive. This was because the clear meaning and intent of article 40.3.3 was to prohibit abortion in Ireland except where there was a risk to the life of the mother.
While the consequences of prohibiting abortion in all other cases (including where there was a fatal foetal abnormality) were raised in the course of the 1983 referendum, and in subsequent referendums, the people nevertheless enacted article 40.3.3 and did not subsequently change its substantive provisions. That article governs our law today, and will do so unless or until it is removed.
Deirdre Conroy takes me to task for raising with Clare Daly TD the fact that neither of her two Bills seeking to implement the X case contained any provision covering fatal foetal abnormalities (“Dáil disrespectful on issue of fatal foetal abnormality”, Opinion & Analysis, July 12th). As the Dáil record shows, I was not accusing Deputy Daly or reproaching her in any way.
In fact, I have in the past commended her for proposing X case legislation. But when she and others demanded in the Dáil that the Government include a provision covering fatal foetal abnormalities, we responded by stating that this was not possible. Not because of an absence of “political courage”, but because of the plain terms of article 40.3.3 and the judgment in X.
It is not open to the Oireachtas to step outside of the Constitution. In my exchange with Clare Daly I was pointing out that neither of her Bills sought to address fatal foetal abnormalities – for the same reason, I suggest, that the issue could not be addressed in ours.
The Government has a clear duty to justify and explain any legislation it brings forward, and this is not “manipulative political rhetoric”. On the contrary, any TD who seeks to convey the impression that the Dáil can ignore the Constitution, when they know full well that we can’t, is not being straight with the people.
The preponderance of legal opinion, including the advice of the Attorney General, is that fatal foetal abnormalities cannot be included in this legislation. I accept that the very stating of this fact can be the cause of hurt and frustration. But I also believe that women faced with such circumstances should not have to leave their own country to have a termination.
To achieve this we will have to change our Constitution. – Yours, etc,
ALEX WHITE, TD,

Sir, – Harry McGee reports that Minister for Finance Michael Noonan finds a proposition to extend the right of multimillionaire tax exiles to reside in Ireland for up to 244 days per year, without further liability to Irish taxation, “attractive” if they were to buy this right in the form of philanthropic payments of €15 million to unspecified charities over a period of 10 years (Front Page, July 15th).
It is odd that he should find this attractive at a time when the State is waging a relentless public relations war across the globe to persuade a very sceptical public that Ireland is not an easy touch when it comes to tax avoidance following the Apple tax controversy in the United States and the deliberations of the G8 leaders in Enniskillen on enhanced international tax transparency.
Apart from that, such a proposition can only have merit in Ireland if it is clearly seen to benefit society as whole – those that reside in the country without reservation and who diligently serve the national interest for up to 52 weeks, not merely 34 weeks.
The fact that the leadership of many charities in Ireland receive remuneration of a scale that is dazzling in its magnitude, and that the State does not even have a charity commissioner to oversee these regimes, hardly strengthens the proposition, nor make it attractive, in the eyes of ordinary hardworking compliant taxpayers struggling, with incredible difficulty, to make ends meet.
However, were the proceeds of such a proposition to be applied, for example, to the Government’s Irish Aid Programme, taxpayers in general would be relieved of some of the obligation to fund this programme as they are obliged to now through additional borrowings of €600 million per annum. The capacity of philanthropy in Ireland and its generous multimillionaire tax exile patrons to personally embrace the United Nations Millennium Development Goals, from an Irish-resident tax perspective, would give some tangible expression to the advocacy of Bono and his passionate belief that 80 per cent of Irish people support this programme – as the funding of it become discretionary and not merely another titanic compulsory tax burden. – Yours, etc,
MYLES DUFFY,

Sir, – The publication of the final chapters of the Murphy report confirms once again the appalling activities and attitudes of the hierarchy of the Irish Roman Catholic Church and its complete indifference to the civil law of this country, as well as a total and cynical lack of consideration for the unfortunate victims of the paedophile priests whose protection seemed to be the overriding concern of their bishops.This is sharp and complete contrast to the public utterances of the same bishops and their masters in the Vatican state who to this day continue to lecture the rest of us with regard to the sacredness of all human life and the absolute need to cherish all children regardless of political, social, ethnic or religious background.
Add to this the servile and supine attitude of the Garda and certain government officials whose sole concern seemed to be the necessity of deferring to their religious overlords, with little or no consideration being given to the victims of clerical crime and certainly no regard being given to their legal obligations under Irish civil law.
This catalogue of abuse, disregard for the law and subservience to the laws and policies of a foreign state, highlights the absolute need to work immediately for the separation in this country of church and State. This needs to begin at a constitutional level and work its way down to the most basic levels of health and education, to cite but two examples.
The Roman Catholic Church, like all representative social and religious groups and organisations in the State, is of course free to lobby and advocate for its particular point of view but it needs to understand that this must take place within the parameters of Irish civil law and that its allegiance and duty is to the people of Ireland and not to canon law and the Vatican.
Perhaps the members of the hierarchy need to consider whether or not their loyalty lies with the Irish State of which they are citizens, or with the Vatican, whose representatives they are in Ireland. – Yours, etc,
HUGH PIERCE,

Sir,– Stephen Collins is quite right – TDs will have to become more involved in the framing of legislation, but any change is not going to come from the top (“Reform of Dáil Éireann is long overdue”, Opinion & Analysis, July 13th).
It is, and always will be, up to backbench TDs, who are after all the majority, to get up off their knees, organise and insist on taking a meaningful part.
Furthermore, the whip should only apply after policy has been agreed by majority decision of the parliamentary party. – Yours, etc,
BRENDAN CASSERLY,

Sir, – The Belfast Agreement enshrined the principle of “parity of esteem”. That concept was sadly lacking in the comments by the returning marching Belfast loyalist last Friday, July 12th, when he shouted at protesters, “You are are second-class citizens, this is our country”. Such comments highlight a mindset that is difficult to comprehend or understand in the 21st century. What will change it? – Yours, etc,
MICHAEL C O’CONNOR,
Dunmore Road,
Waterford.
Sir, – How can the Orange Order walk the “Queen’s highway”, when some of their supporters insist on breaking it up and throwing it at the PSNI ? – Yours, etc,
JOE DALTON,

Irish Independent:

* Last week, the most exclusive nightclub in Ireland, Dail Eireann, finally decided to do the right thing and put in place a legislative framework to ensure the constitutional protection of “the right to life of the unborn. . . (which) guarantees in its laws to respect, and, as far as practicable, by its laws to defend and vindicate that right”. However, in doing so it overlooked the obiter dicta of Mr Justice Hederman in the X Case:
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“In cross-examination the psychologist said: ‘My recommendation would be she was not safe unless under supervision. I would have thought, given the state which I found her in, in-patient treatment would be essential. . .’
“If there is a suicidal tendency then this is something which has to be guarded against. If this young person without being pregnant had suicidal tendencies due to some other cause then nobody would doubt that the proper course would be to put her in such care and under such supervision as would counteract such tendency and do everything possible to prevent suicide. I do not think the terms of the eighth amendment, or indeed the terms of the Constitution before amendment, would absolve the State from its obligation to vindicate, and protect the life of a person who had expressed the intention of self-destruction. This young girl clearly requires loving and sympathetic care and professional counselling and all the protection which the State agencies can provide or furnish.
“There could be no question whatsoever of permitting another life to be taken to deal with the situation, even if the intent to self-destruct could be traced directly to the activities or the existence of another person.”
Almost immediately, attention has focused on a strategy for ensuring that the bill is not declared unconstitutional by the Supreme Court, for example whether referral by the President is better than waiting for the provisions to be challenged in an appropriate test case.
What most commentators appear to have overlooked is that the bill has still to be debated by Seanad Eireann, a body that our Taoiseach will be asking us to abolish this autumn.
Many members of the Seanad are arguing that it has a vital revising role to play with regard to legislation. Now it has a chance to prove its worth.
Our senators can amend this legislation so that it accurately reflects the provisions of our Constitution and the nuances of the Supreme Court judgment in the X Case, including the right to life of all those with suicidal ideation (not just pregnant women).
If they do so, then they will have earned the right to life for Seanad Eireann; if they act as a rubber stamp for the decision of our exclusive nightclub, then the life of Seanad Eireann deserves to be terminated.
John Hearn
Malahide, Co Dublin
CHURCH GATE COLLECTION
* I note that ongoing moves by our politicians to separate church and State do not include the annual church gate collections – with Fine Gael’s collection being held at the gate of my local church yesterday morning! M Bourke
Newport, Co Tipperary
A COWARD’S BLOODSPORT
* The goring of several men in the annual Pamplona bull run has drawn attention again to this barbaric festival that poses a threat to humans and animals alike.
You risk being injured or even killed when you take your chances in the event, and the bulls are routinely killed afterwards, some in bullfights where they are stabbed repeatedly before being put out of their misery by a swaggering caped man wielding a sword. Both practices are stains on civilisation.
So, too, are other forms of recreational animal cruelty. Ireland’s answer to the bull run and bullfighting is hare coursing. We have more than 70 coursing fixtures every year.
There are differences, though. Unlike the bull, the Irish hare is a meek, gentle creature that is easily frightened. In Irish coursing, unlike in Pamplona, it is the animals that do all the running and the fans take no risk whatsoever.
Having captured the hares and confined them in wired compounds for weeks, they are forced to serve as live bait. On coursing day, the fans and club officials wrap themselves in snug winter garb while the hares perform in torrential rain, snow or hailstorms, or on water-logged fields.
They stand, or sit, in safety and comfort as the hares are mauled, pinned to the ground, or tossed about like rag dolls.
The fans imbibe whiskey or brandy from flasks as a mammal that survived the Ice Age is forced to run in terror from hyped-up greyhounds.
It is interesting that in Spain people feel a need to dress up animal cruelty as a challenge – a test of manliness and courage. They think of the event, perversely and misguidedly, as a showdown between man and bull. Here, hare coursers don’t even pretend that the animal they target for their gratification could ever stand up to them.
Bullfighting and bull-running may be among the bloodiest cruelties ever devised. But hare coursing could surely rank as the world’s most cowardly bloodsport.
John Fitzgerald
Campaign for the Abolition Of Cruel Sports
ALWAYS NEXT YEAR
* No one died in the Pamplona animal cruelty bull run?
Oh well, there’s always next year.
Robert Sullivan
Bantry, Co Cork
FEMINISTS OUT OF TOUCH
* It was widely reported in the international media recently that two girls, both aged 15, were shot dead in Pakistan for the ‘crime’ of dancing outdoors in the rain in front of a video camera.
They were killed when village elders decreed that their behaviour was ‘un-Islamic’. Women are routinely flogged and sometimes beheaded for the ‘crime’ of adultery in some of those Islamic countries.
But what’s really puzzling here is the fact that amid all this savagery there hasn’t been a squeak out of those women who call themselves ‘feminists’, such as the National Women’s Council of Ireland, which was up in arms last week over what some in the media ridiculously named ‘Lapgate’.
These so-called feminists remind me of the last Pope who was so out of touch with reality that he proclaimed ‘Harry Potter’ was an evil influence on children, while at the same time he himself played dumb over the issue of child abuse by priests.
Those so-called feminists should be ashamed of themselves for playing the dumb card while their sisters are battered and brutalised by misogynists who use religion as a camouflage to carry out evil deeds.
They should be in the streets demonstrating on behalf of the victims, and putting pressure on politicians to get this issue put on the agenda at the UN.
Paddy O’Brien
Balbriggan, Co Dublin
MAY HE REST IN PEACE
* In the ‘Review’ section of the Irish Independent (Saturday, July 13), I read the obituary of Masao Yoshida and it cheered me up no end.
I was greatly saddened by the news of his death from cancer at 58 years, but I was cheered to be reminded that there was such a man who, when the nuclear plant at Fukushima was devastated by an earthquake on March 11, 2011, and there seemed to be no hope, stood tall with his team, and manned the pumps in defiance of his bosses.
This cost him his life and possibly the lives of others in his team but their actions saved so much.
May he rest in peace.
RJ Hanly
Screen, Co Wexford
Irish Independent

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