Whenever Theresa May finds herself in a corner over the NHS she repeats the mantra: you require a strong economy to have an NHS in the first place (Marr grills May, 1 May). That is a classic example of a necessary but not a sufficient condition. It obviously helps to have a strong economy but a nation has to get other decisions right.
The US has a strong economy but a seriously deficient public health service due to large reliance on insurance companies for facility and corporations providing health cover for employees.
Cuba has a weak economy but an excellent health service due to the right decision on prioritising public health.
In the UK the NHS is in difficulties due to the Tory government prioritising tax breaks for corporations and the better off instead of using the finance to meet the needs of an ageing population with increasing quantities and complexities of treatments required. PFI and privatisation have also not helped.
Nigel de Gruchy
• The political shock-horror of the shortage of nurses misses the point of why so many NHS staff are not British or/and are leaving. At the weekend I had a cardiac physiologist to stay – ie, not a doctor or a nurse but an essential member of the team dealing with heart attacks on emergency call-out at night, and for checking heart problems during the day. The night on-call emergency rotas are made to follow a full day’s work, so no sleep for up to 24 hours is common. It is worse when you are sent home at about 4am and drop into an exhausted sleep only to be woken again to go to work an hour or two later (or not daring to sleep in case the phone rings). My guest says jobs are harder to fill in hospitals where you can be on call for a night in between two normal days – ie, up to 36 hours’ continuous working for patients who are in immediate danger of death.
These staff do not have the powerful BMA doctors’ union acting for them, and such practices have become normalised and in agreement with unions. Politicians claim to be making the best use of taxpayers’ money. Not in my name please! Sleep deprivation is the reason my guest and many others are looking to leave the job they otherwise found satisfying after years of training and building up their expertise.
Name and address supplied
• I wish to point out the connection between the two articles on cancer drugs and end-of-life care in Friday’s paper. In the cash-constrained NHS, expenditure in any area means that money cannot be spent elsewhere. So when £1.27bn goes on very expensive new cancer drugs (Report, 28 April), not curative and with zero or marginal outcome benefit, it cannot be spent on specialist palliative care or “hospice at home” services. The consequence is that those same patients, within weeks, cannot be supported in their wish to die at home (Report, 28 April). Many more people would have been helped by the latter investment.
Dr Charles Turton
Burgess Hill, West Sussex
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