15-07-2025
Times letters: Improving the way the NHS cares for patients
Sir, Jenni Russell's experiences result from a complex reality that sweeps the workforce along like hamsters on a wheel ('NHS needs to return to whole-patient care', Jul 14). Yet another restructuring will not solve the problems. To understand why, start with the fact that – until Margaret Thatcher's introduction of 'a business market' with competing hospital trusts — the NHS was generally based on 'doctor knows best'. This meant that a professionally accountable clinician was directly responsible to a patient or group of patients and the centralised public NHS system supported this. Once trusts were formed, with layers of management and financial silos, the 'business' became managing not the care but the money. Clinicians had to prioritise budgets and politically useful targets or face chastisement by managers. The NHS's business focus should be ensuring people are healthy in their own homes, supported by joined-up services. Instead it is concerned with financial efficiency and meeting targets at the expense of effective outcomes.
Bernice Baker
Horsham, West Sussex
Sir, I came to similar conclusions as Jenni Russell, in my case as an inpatient at the emergency department of one north London hospital and an outpatient at another over the past 12 months. It is vital to develop a culture where nursing staff look out for problems or are at least open, rather than defensive, when one is brought to their attention by a patient. It is very difficult for patients or families to navigate the people, departments and functions of a hospital, which makes it particularly important for any point of contact to pass on a problem brought to them to whoever can deal with it best.
Michael Rose
London N10
Sir, My recent experience of the NHS confirms Jenni Russell's conclusion about inconsistency of quality in different parts of the country, but also offers an encouraging note. After having pneumonia, I developed a rare, potentially disabling auto-immune condition. This was diagnosed by my GP with stunning speed. She liaised with the A&E department of the local hospital and phoned me to tell me what to do. The A&E consultant confirmed the diagnosis, took me to an emergency bed and called in on me every day during my week in hospital, even though he had handed my care to others. My care was so prompt and effective that I began to recover in near record time.
John Schultz
Stockport
Sir, The job of the independent pay review bodies is to take evidence from the professions about what they are hoping for and then evidence from the government to see what the country can afford. They then issue findings on what they think is fair. Almost without exception, governments find reasons to reject the proposals. If this government has learnt anything from the debacle on doctors' pay it is this: honour the review bodies' findings.
John Brown
Ret'd GP, Newcastle upon Tyne
Sir, The blinkered behaviour of the various groups of hospital staff that Jenni Russell describes was brought home to me when I took a patient I had anaesthetised to the recovery ward. I said to the recovery nurse, 'I'm afraid he's been incontinent and needs a bit of cleaning up.' She replied, 'I'm a graduate. I don't do that sort of thing.' So I asked for a pair of rubber gloves.
Jane Stanford
Ret'd consultant anaesthetist, London SW13
Sir, As a soldier, one of the few things that you hope you can rely on is that the government has got your back. If you obey lawful orders, adhere to international humanitarian law and the law of the land you should be all right. That bedrock, that fundamental premise, is threatened by the government's desire to rescind parts of the Northern Ireland Troubles (Legacy and Reconciliation) Act 2023 ('Traumatised by the Troubles', news, Jul 12). That act, while not perfect, was a brave attempt to support the peace-making process in Northern Ireland, and to protect service personnel and police officers from vexatious legal action brought by the families of, mostly IRA, terrorists who had been lawfare against former Crown servants stemmed from relatively recent interpretations of the 1998 Human Rights Act, an act which, ironies abound, was itself written into the 1997 Good Friday agreement. To be clear, the best thing for the authorities to do is nothing: leave it alone. But how telling that a government that has called for a 'national effort' to build defence and security resilience is willing to throw its protectors to the wolves. Can you seriously tell future veterans that they will be all right while simultaneously permitting the persecution of current veterans? I think not.
Colonel Simon Diggins (Ret'd)
Rickmansworth, Herts
Sir, There is no doubt that after the shooting of Jean Charles de Menezes, Sir Ian Blair (as he then was) was poorly served by being supplied with wrong information about the identity of the deceased, which he innocently disseminated but for which he was unfairly criticised (obituary, Jul 12). But his decision to contest the health and safety trial that followed (in which I was leading counsel) was not only the correct one but was vindicated by the jury's rider attached to the guilty verdict, which exculpated the senior officer in charge, Commander Cressida Dick, thereby separating individual fault (of which there was none in her case) from institutional blame.
Ronald Thwaites KC
Esher, Surrey
Sir, As problems with the BBC mount, the causes and solutions become evident ('Ofcom chief: BBC losing trust with slow response to crises', Jul 14). The causes are the adulation of 'talent' and top editors, together with excessive pay, which partly shields them from the real world; it is inward looking, with editors who are overly defensive in the face of complaints; there is a lack of diversity of thought and background among journalists and producers (too many are privately educated and only 20 per cent of employees describe themselves as working class); and Ofcom has too many members with a media background. The solutions are to swiftly delegate complaints to an independent ombudsman; limit Ofcom members from the media; and make a real effort to hire and hear contrarian voices at all levels of the BBC. This is not to deny that the BBC is the best broadcaster in the world. It will remain so with these changes.
Baroness Deech
House of Lords
Sir, Your leading article ('Not a Fan', Jul 14) risks overheating your readers: you say 'insulation, poor ventilation and triple-glazed windows are all designed to actively trap heat'. But triple glazing is cleverer than that: it has a higher g-value than double and single glazing, which means less light gets through (so is not converted to heat on hitting a surface) and a lower u-value, meaning less heat gets through than with double and single glazing. This means that triple glazing is better at keeping heat out in a heatwave and is to be applauded, not vilified. Good insulation also delays the intrusion of heatwave heat. Only poor ventilation is a scourge. When cooler evening air arrives, open the window.
Nick Owens
Hassocks, West Sussex
Sir, John Hicks backs Reform because he wants to see a more homogenous society and the benefits that may bring (letter, Jul 14). No political party can deliver this from the top. It is created 'bottom up' and is unlikely to change after an election. Indeed, it is debatable whether an homogenous society is better than the rich, multicultural society in the UK today.
Christopher Bellew
London W6
Sir, You report that the government is considering measures to improve electric vehicle uptake (news, Jul 14). Surely a much better way of achieving the goal would be to introduce a tariff on Chinese-built electric cars. The EU (which charges 17-37 per cent) and many other countries have done this already. This would encourage the purchase of electric cars built in Britain and the EU. The market dominance of Chinese makers of EVs is widely under-recognised, given that many have European badges, including MG and Volvo.
Dr Graham Moyse
Broadstone, Dorset
Sir, Communion wine with reduced alcohol can be essential for priests who have a number of services on a Sunday and have to drive between churches (news, Jul 11; letters, Jul 12 & 14). Drinking a lot of full-strength wine is a challenge. This was especially so when services resumed after the Covid lockdowns. Nearly every communicant dipped their holy wafer into the chalice instead of drinking from it, which meant that hardly any wine was consumed. It is the priest's duty to finish the sacred elements and the servers would not help because of the virus fears. In my case, the only solution was to heavily water down the chalice so that I could arrive at the final parish clearheaded.
Canon Brian Stevenson
West Peckham, Kent
Sir, Now the Wimbledon excitement is over ('Slick Sinner serves up a 'beautiful' final', Jul 14), may I air a couple of thoughts for the future. Surely I cannot be the only person to be irritated by the TV coverage when it picks people out in the crowd. Perhaps the BBC thinks we know who they are, but we're here to watch the tennis not some minor celebrity, even if they are in the royal box.
John Wallinger
Upton Grey, Hants
Sir, You report that 'between them, the four richest Africans are worth $57.4 billion — equivalent to the wealth of half of the continent's population' (news, Jul 11). The next day AN Wilson wrote in comment: 'The worldwide phenomenon of migration, caused by wars, famines, climate change and other huge factors …. will keep on happening.' Could these phenomena be connected?
Nick Butters
Newcastle upon Tyne
Sir, On the day that the England and Wales women's football teams competed in an international match, Sir Keir Starmer chose to don a full England kit while himself playing football ('Best foot forward', Jul 14). Perhaps he needs reminding that he was elected prime minister of the UK.
Shimon Cohen
London N2
Sir, After the Brighton bomb, Lord Tebbit and his wife were admitted to the spinal injuries unit at Stoke Mandeville Hospital, where I was an inpatient (obituary, Jul 9). Despite dealing with their injuries and the trauma of the bombing, Lord Tebbitt showed kindness and compassion toall of us on the ward, with daily inquiries about our welfare.
Hilary Jacklin
Polstead, Suffolk
Sir, Any misdemeanour eliciting a cry of 'sorry' (letter, Jul 14) in my first term at Sandhurst in 1966 was met with, 'You're not sorry, you're wrong.' Ever since, saying that I am wrong when I am has been instinctive.
Malcolm Watson
Ryde, Isle of Wight
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