Letters: ‘Confidence’ in chief of the NHS

These letters appear in the print edition of The Independent, Friday 8 March

Sir David Nicolson has said that he will not resign. The Government has given him backing so he will not be fired.

The Government is about to implement innovations that have the wholehearted support of neither the professionals nor the public. Who then better to bring in these controversial changes than a man whose reputation is in tatters? When the innovations fail he will be blamed and fired, and the new man will start with a clean sheet.

Just as in football, when a manager gets “the confidence” of his chairman, what inevitably follows?

Professor A G D Maran, Former President, Royal College of Surgeons, Edinburgh

The NHS just saved my life. With no prior symptoms, I suffered a minor heart attack on 18 December. Three hospitals, three ambulance transfers, upwards of 50 dedicated professionals, and nine days later, I had had a world-class triple bypass to remedy a previously undetected life-threatening condition.

I was kept informed throughout of what was happening and why, with clarity and sensitivity. At all times I was treated with unfailing care and concern, as a patient and a person.

When I thanked one of the surgeons, he smiled and said that it was a team effort and that the contribution of nursing and support staff was equally important. I witnessed a level of teamwork, personal commitment, discipline and professionalism by staff at all levels that I never encountered in 20 years in industry, much at senior management level.

Nightmares like Mid-Staffordshire are not caused by accumulated pressures created within the value-structure of either medicine or the NHS. They are generated by the ignorant, simplistic misapplication of long-discredited business techniques by politicians and civil servants who have never run anything except a doubtful argument.

The corporate vultures are circling the NHS, scenting red-blooded profit. Driven by ambition and half-baked prejudice about a critical area of our public life, our naive politicians are easy prey for the first snake-oil salesman with an easy pitch.

Hospitals are not businesses. Patients are not customers. But my albeit anecdotal experience demonstrates that the NHS already has a level of disciplined, rigorous, empathic delivery of a life-and-death service that would be the envy of any private enterprise.

All it needs is for politicians to listen to the professionals who run it and who have dedicated their lives to the principles and values it enshrines. Then shut up and find the money to save it.

Keith Farman, St Albans, Hertfordshire

The comments by a Doctor Thomas E Rardin from the American Medical Association and quoted in The Lancet in January 1961 should remind us what good medical practice should be. The quote is from a paper on aplastic anaemia, including that caused by exposure to TNT in munitions workers and quotes a death rate of 34 out of 45 patients.

“Patients are fearful, suspicious, doubtful, sensitive, anxious and often lonely. Their greatest need is to feel close to those around them. Each person in the hospital setting becomes important to the patient, because he believes each one knows something about him.

“Whether it is the clean-up girl, an intern, a nurse or an attending physician, the patient needs to identify strongly with optimistic, kind, understanding and supportive people. There is no more effective medicine than kindness, nor is there any substitute for it.

“It is an essential ingredient in all human relationships. When one is frightened and lonely, a cold, disinterested and indifferent attitude on the part of attending personnel can be devastating.”

Edward Priestley, Brighouse, West Yorkshire

Your news report about the millionth refugee from the civil war in Syria hides one of the reasons behind the awful upheaval in the Arab world (7 March).

The millionth refugee, Bushra, is 19 years old. She has two children, the elder of whom is four years old. That means that Bushra was made pregnant when, at most, she was barely 14.

As long as we Arabs persist in such obscurantist and inhuman treatment of women, our society is not likely to move into the free and liberal world that our younger generation strives for so earnestly and at such high cost in blood.

The Syrian regime has caused untold suffering to its people. Arab social norms have regrettably helped and the obscurantism exampled in Bushra’s life is beginning to show through the rebel forces. The only negative quality to equal it is Western hypocrisy in tutting incessantly and doing nothing.

Dr Faysal Mikdadi, Dorchester, Dorset

The arrival of the millionth refugee across the Syrian border is a stark illustration of a crisis that is bringing fear, pain and suffering on a massive scale. Within Syria, violence is intensifying and more than four million people, at least half of whom are children, are in urgent need of assistance.

But a chronic lack of funding is threatening to leave many Syrian children without essential assistance. Unless an 80 per cent funding gap is bridged very soon, Unicef will be forced to scale back on even life-saving interventions.

Following a sudden disaster such as an earthquake, public generosity is mobilised, funds pour in, political decisions are made to ensure that relief reaches those in need. The situation in Syria is not a natural disaster, but the suffering of Syria’s children is no less extreme.

David Bull

Executive Director, UNICEF UK,

Baroness Miller of Chilthorne Domer

Helen Goodman MP

(Bishop Auckland, Lab)

Cathy Jamieson MP

(Kilmarnock & Loudoun, Lab)

Russell Brown MP

(Dumfries & Galloway, Lab)

Andy McSmith’s reference (6 March) to a confrontation between Peter Mandelson and me elides two separate episodes. It is true that Mandelson, then a member of the advisory board of Independent News & Media, which owned The Independent, did “march up” to me at an Economist party in the National Gallery, but he did not refer to Andy.

He was (very) angry about the newspaper’s stance on the Iraq war, particularly a front-page story that morning critical of Tony Blair, which he called “disgraceful”. He threatened to resign from the INM board, which he did, but some months later.

His complaint about McSmith was a separate affair. As I recall it, the two had “history” going back some years and didn’t like each other very much. Mandelson felt that McSmith was pursuing something of a personal vendetta against him whereas Andy, not unreasonably, felt comments he made in The Independent criticising the war were fair and reasonable (and he was right).

It is true that I did convene a meeting at which the two of them had a good shout at each other and Mandelson dropped his demand for an apology or retraction. But it is not true that Mandelson objected to McSmith’s hiring – he was already hired – and nor did he demand his sacking. It was not the kind of thing he did.

Ivan Fallon (Former CEO, Independent News & Media UK), Cape Town

I find it almost unbelievable that a government can announce that they will use evidence-based research to examine which initiatives work and, by implication, which don’t. As the first line of your report (4 March) says, “It is, one might think, what a good government would be doing anyway”.

One has to ask what are the policies of successive governments based on if not evidence. Are policies based a whim, an ideology, a thought or a chat over a pint? It is no wonder we suffer from U-turns. It is astounding that policies are made without reference to history, social and economic evidence, and the evidence available from universities and other research bodies.

What will a government do if the research conflicts with their political stance? What if free schools and academies don’t raise standards? What if prisons do not lead to a reduction in crime? What if benefit cuts actually harm people?

Graham Jarvis, Leeds