Don't forget about mental health when discussing the NHS crisis

Your review of the TV documentary Hospital mentioned that 7,000 NHS beds have been lost in England over the last six years, but the actual total is much larger. Official NHS data show that available general and acute medicine beds have reduced by 9,000, while those for mental health and learning disability have declined by 6,000, giving an overall loss of 15,000 beds. So far, so bad.

But this is not the most alarming part of the story. One in 16 beds have been lost in general and acute medicine – but one in five beds in mental health. Given that mental health services had already, in the move to community-based care, lost the majority of their beds, this subsequent reduction seems particularly disproportionate.

As a result, the remaining mental health beds have been continually over-occupied. The accepted level of bed occupancy for efficient use is 85 per cent – for mental health, this has continued to increase from 87 per cent in 2011 to over 90 per cent now. The pressure on these beds, already excessive, has reached a level that too often renders impossible any efficient management of these expensive resources.

We have heard much from politicians, and others, of the notion of “parity of esteem” for mental health services. The inexorable degradation of these services suggests that this phrase has become a sentimental nostrum to disguise political inertia and disinterest rather than a genuinely felt activating principle that could drive significant change. Meanwhile, time that should be spent with patients is, instead, frittered away in wrestling with successive bed crises, each of which follows hot on the heels of the last.

Dr Philip Timms FRCPsych, honorary senior lecturer, KCL
London

Anybody familiar with Freudian Theory will be aware of defence mechanisms, the means we use to avoid responsibility or self-awareness.

None of the current Health Ministers are competent or qualified to do their jobs. Theresa May has no experience whatsoever in this area. Claiming that the crisis in the NHS is down to GP surgeries not being open for long enough is either projection or displacement.

The result of these two defence mechanisms is scapegoating and that is exactly what she and

Hunt especially are doing. She's even gone so far as to make the statement about GPs from “Downing Street” rather than herself.

They are responsible, let's be clear, not GPs.

Terry Maunder
Kirkstall

Julian Self wrote (Letters): “Each time there is a Southern rail strike or an underground strike, I keep seeing letters in the press calling for the outlawing of strike action for ‘vital public services’, which I find rather unsettling.” I question only his wording: “Each time there is a Southern rail strike”. There is just the one strike and it has taken place for months (and continues to do so) on various weekdays every week. It's a massive annoyance and inconvenience, wasting potential working hours of each those days for thousands of people (and companies).

I agree with Julian Self about the dangers of a non-strike bill, but they are irrelevant in this instance because as the terms of their franchise currently stand Southern is impervious to strike action. Bosses get paid even if they run no trains.

Chris Grayling's pronouncement that he would not consider allowing TfL to take over Southern on the grounds that he could not bear to see it in the hands of a Labour London mayor is an insult to companies, workers and other members of the public who rely upon Southern rail services. He publicly puts his perception of the good of his party over any good of any citizen of his country. What a little man. And what a poor understanding of (or, worse, acceptance of) the ebb and flow of democratic elections. Is there any hope that we can see the end of such people in public office any time soon?

Beryl Wall
London, W4

It is more than strange that leaders of a Christian cathedral should consider it appropriate to read passages of the Islamic holy book, which contradict the teaching of Jesus, during a service.

It is most appropriate that leaders of a Christian church should find opportunities to inform their flock about teachings of other faiths, so individuals are able to understand their neighbours and build positive relationships with those who are not familiar with the Christian faith.

However, Church services are about worshipping God, Jesus and the Holy Spirit, and building the faith of church members rather than giving voice to ideas, whether from atheists or other faiths, which deny teachings of the Bible.

J Longstaff
Buxted

In his criticism of the phrase “going forward” used in a news report, John Rentoul mused: “One of these days there will be an event that affects people going backwards.”

There is. It's called Brexit.

Terence A. Carr
Prestatyn

Step 1: Trigger Article 50.

Step 2: Negotiate an exit deal that is better than no deal at all.

Step 3: Deal is approved by the EU.

Step 4: Deal is not approved by the Commons.

Step 5: Exit without a deal.

Lee Davis