Tuesday 14 June 2011

Council house abuse, the care home scandal, and reforming the NHS

Letters from the Telegraph Weekly World Edition, Issue 1,038 

SIR – Why take council houses away from people earning £100,000 (report, Issue 1,037)? About £30,000 might be a more realistic figure. And why has this problem just been identified? Who has allowed this situation to develop over the many years?
Why are they not prosecuted for outrageous abuse of public money, taken in tax from citizens who work hard for rather less?
William Foot, Ely, Cambridgeshire
SIR – There is no need to evict high earners from council housing.
All that is required is to set rents at a realistic level and then provide discounts based on need and income so that needy people are protected. High earners will then pay a fair rent and can decide whether to move or not.
Subsidising the person not the house will provide more houses, by either freeing them up or raising more money.
Dennis Spruce, Welwyn, Hertfordshire
Health reforms
SIR – Andrew Lansley, the Health Secretary, fails to make a plausible connection between his doomsday predictions of a doubling of the costs of the NHS by 2030 (report, Issue 1,037), and his proposals to hand the money to the doctors and town halls. While improvements in efficiency are needed, they are nowhere near enough to cover the rising costs from an ageing population and technical advances.
Either new money must be found for the NHS from the users, or services must be reduced. Since the second option is unacceptable, the only realistic source is to fund about half the NHS from mandatory insurance premiums, paid by those in work. I am not optimistic that the British public is yet ready to accept such a reform.
However, the elephant in the room is the large number of doctors who can’t wait to leave the NHS. This could bring the system down without warning.
Harry Fuchs, Flecknoe, Warwickshire
SIR – Mr Lansley showed that an ageing population, financial pressures, and medical advances all mean that we need to change the way services are provided. GPs are certainly best placed to make decisions to guide the way health services are designed.
They do not need to become expert commissioners, but they do need to understand the bigger picture. In Bexley, GPs are getting to grips with the wider needs of the population, working together to fulfil these needs, while trying to plug a funding gap of about £20 million.
Surprisingly to some, the changes we have made mean that getting better value for money actually means better services for patients: redesigning patient pathways according to the patient’s needs prevents costly and inconvenient unnecessary trips to hospital, inaccurate diagnoses and inappropriate referrals.
GPs need to get organised. Otherwise, we are at risk of the planned reforms becoming yet another expensive, top-down reorganisation that achieves little for our patients.
Dr Howard Stoate, Chairman, Bexley Clinical Cabinet, Bexleyheath, Kent
A duke to treasure
SIR – Your well-deserved tribute to the Duke of Edinburgh before his 90th birthday (Comment, Issue 1,037) did not mention one aspect of his work that probably has had the biggest impact on the public good: his patronage of and support for many charitable causes.
He has lent his name to more than 700 charitable causes, most notably the Duke of Edinburgh’s Award, which benefits more than 275,000 young people annually.
Much of the good work he does goes unrecorded, such as the ceremony he presided over recently at Buckingham Palace for the presentation of the Templeton Prize, the world’s largest annual monetary award for achievement in the sphere of religion and belief.
I really think that the Duke of Edinburgh should be counted among our national treasures.
Sir Sigmund Sternberg, London NW5
Refreshing Telegraph
SIR – Having just read Issue 1,035, it is so refreshing to ingest some good British journalism.
The articles, whatever your political and social persuasion, by Mary Kenny, Con Coughlin, Frederick Raphael, and not forgetting Boris Johnson, are poignant, pithy and profluent in their content. Such a difference from the disingenuous pap dished up by newspaper journalists over here in the US!
Well done The Telegraph, keep up the good work.
William Cousins, Colorado, USA
Currency innovation
SIR – You report (Business, Issue 1,037) that Jean-Claude Trichet, the head of the European Central Bank, has called for the creation of a European finance ministry to intervene in national economic policy.
But isn’t there a more straightforward solution to the problems being experienced within the eurozone? Each country could have its own currency rather than sharing a common one, and global markets would continually adjust the rates of exchange between them.
A bit radical, but it might be worth a try.
Roger Manning, Weybridge, Surrey
Cost of Apaches
SIR – There may be a hidden cost to the deployment of Apache helicopters in Libya (report, Issue, 1,037). The Apache was never designed for prolonged operation in a marine environment and lacks the corrosion protection given to naval aircraft.
When the deployment is over, the aircraft will therefore need an extensive strip-down to search for corrosion, followed by a rebuild, if economically viable. This was required for the RAF Harriers that took part in the Falklands campaign.
Of course, the aircraft will be unavailable for service for a prolonged period while this work is undertaken. Ironically, when the Apache was being selected, a competitor was the Cobra. Apart from being cheaper and more suitable in other ways, the Cobra had been designed for the United States Marine Corps and had protection against sea corrosion built in.
James Roe, Bedford
Care home scandal
SIR – After the reports of abuse at Winterbourne View care home (reports, Issue 1,037), more scandals will emerge, I fear, because of changes in the inspection system.
Until 2008 I was a regulation manager for the Commission for Social Care Inspection. Inspections were rigorous and services were rated using a star system. Poor services were inspected several times a year; if improvements weren’t seen, they would be closed. Inspectors had local knowledge and understood the services.
With the advent of the Care Quality Commission (CQC) in April 2009, the star rating system was abandoned. Inspectors foresaw that this might lead to inadequate regulation. In my view, the CQC’s intelligence-led and “light touch” approach may have contributed to the latest scandal. After the CQC took over, the teams of inspectors with local knowledge were disbanded. And abandoning the star system meant there was no need for an annual inspection programme, so fewer inspectors were needed. The government wanted a cheap form of inspection, and now vulnerable people are paying the price.
John Walker, South Godstone, Surrey
SIR – The staff charter of the operator of Winterbourne View, Castlebeck, states that, as a new member of staff, “you can expect to be treated with dignity, respect and support”. It is sad that the people in their care did not receive similar treatment.
John Adams, London N7
Quick work on eye op
SIR – I read with interest Peter Pallot’s article on “Japan’s prized health system” (Issue 1,033). However, not all hospitals keep patients in for three nights for cataract surgery. My husband has just had this surgery at one of the top private university hospitals in Tokyo with just a one-night stay.
Source http://www.telegraph.co.uk/
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