SIR – You report (June 30) that almost 19,000 family doctors plan to leave the NHS in the next five years due to retirement, stress and burnout.
Another reason is that the current role of GPs is boring and a reflection of what they have become – public-health doctors buried in vaccination programmes, time-consuming and impersonal remote consultations, overwhelming bureaucracy and failing management.
Look at what has been taken away from them: acute medicine and maternity care. These areas were what formed the long-term bond between doctor, family and community.
To restore general practice, GPs need to be allowed to provide 21st-century care, accommodating specialisation and embracing high-tech diagnosis and therapy. Central to this is speed of access in the appropriate setting to specialised doctors. GPs should be able to work as specialists and team up with secondary care to develop a fully integrated personalised service. GPs need to be allowed to do what they were trained to do: practise medicine.
John Fielding FRCS
SIR – A major problem with early cancer diagnosis in this country appears to be that GPs – gatekeepers of referrals for diagnostic tests – are reluctant to make referrals, preferring to treat the symptoms as more minor diseases. Theresa Whitfield (Features, June 30) was fobbed off twice and had to demand a private referral before her bowel cancer was diagnosed.
My mother’s pancreatic cancer was treated as a stomach upset and my father-in-law’s stomach cancer was treated as a hiatus hernia. In both cases they were only correctly diagnosed after admission to A&E, when it was far too late. A friend’s brain tumour was treated as iron deficiency and he was about to use his private medical insurance to see a neurologist when he suffered a seizure. Again, he received a correct diagnosis on admission to A&E.
If it is possible that the cause of symptoms is life-threatening, this should be ruled out by an appropriate test before it is assumed to be a less serious problem. Ideally, common diagnostic tests should be available at local health centres rather than requiring referrals to major hospitals.
Only when cancers are identified early will the survival rate in Britain match those in comparable countries.
SIR – Last week I phoned a local hospital to chase an appointment – six months overdue – for a deteriorating condition. I was told this could only be sorted by having my GP intervene, despite the fact that GP appointments are almost impossible to obtain.
One half of the NHS is encouraging us to take responsibility for our health. The other half seems equally determined to hinder us from doing so.
Fall of Hong Kong
SIR – When I arrived in Hong Kong in 1960, I could not envisage that it would become what it is today (“Hong Kong crushed”, Leading Article, July 1). The territory that served as a safe haven for Chinese refugees fleeing the mainland in the 1950s bears little resemblance to Hong Kong now.
As Benedict Rogers points out, China’s “violations of the Joint Declaration show that Beijing’s signature on any agreement is hardly worth the paper it is written on” (Comment, telegraph.co.uk, July 1).
The arrest of 90-year-old Cardinal Joseph Zen in May was a stark reminder of China’s long-standing persecution of Christians on the mainland. But who is to say that the religious freedom that prevailed under the British for generations is secure under Hong Kong’s draconian national security law?
Denver, Colorado, United States
Pincher and the PM
SIR – The appointment of Chris Pincher MP by the Prime Minister in spite of suggestions of misconduct adds further doubts as to Boris Johnson’s judgment (“PM ‘turned blind eye to sex pest warnings’”, report, July 3).
There is a distinct lack of direction in Government, and it is arguable that the best weapon in Nicola Sturgeon’s arsenal for a second independence referendum is the PM himself.
There has to be a complete change in the Government’s approach. It has to be seen to be providing new policies to tackle the problems facing the country, rather than just reacting to new shocks. If the PM is incapable of such leadership, he must stand down.
Private parking fines
SIR – I have just paid £242.89 for pulling off the road for 17 minutes, unaware that the leafy lay-by was a car park with solar-panel cameras managed by a private company (“‘Rip-off’ private parking firms drive record number of fines”, report, July 2). The appeal process is in name only.
When will this iniquitous, ubiquitous trade be controlled?
S D Curtis
SIR – Car parks run by local authorities are beginning to insist on prepayment via an app. Their terms and conditions say there is no guarantee that a parking space will be available. How can this be legal? Surely it is taking money by false pretences if the fee is non-refundable and applies to a specific time.
Port Erin, Isle of Man
Slog to the seaside
SIR – I well remember our annual trip from Nottinghamshire to the seaside at Mablethorpe, Lincolnshire to stay at Mrs Wells’s guest house (Letters, July 2).
The journey was a little over 60 miles but took the best part of a day in my mother’s Standard Eight. The first lavatory stop was only after about 15 miles, just outside Newark, and soon after we had the tension as to whether the car would make it up Leadenham Hill, loaded as it was for a two-week holiday. I still remember the knot in my stomach, wondering if we would make it to the top. Finally there was the excitement of who would be the first to spot the sea.
There followed 14 wonderful days of soggy woollen swimsuits, camp coffee on the esplanade and endless hours on the penny slot machines in the arcade.
Blessed with wind
SIR – As a retired major project director at BP, I can say that David Frost’s arguments for gas power are wrong (Comment, July 1).
He argues that “medieval wind” will be more expensive since we’ll have to maintain a gas network to act as a backup. This is not the case. At historical gas prices, the running costs of a gas power plant are about £75/MWh, and double that at today’s gas prices. The latest UK offshore wind prices are £40/MWh. Generating power from wind with gas as a backup will cost £50/MWh overall. Wind power will reduce gas demand by 75 per cent, dramatically improving energy security. Cutting-edge turbines will reduce these costs even further.
We are blessed with excellent conditions for offshore wind – the North Sea is a windy place and we have a large continental shelf where we can install low-cost turbines. Let’s exploit this wonderful British resource. It will be cheaper and better for the planet.
Dr Colin McGill
SIR – I am so appalled by the behaviour of Nick Kyrgios in his match against Stefanos Tsitsipas (Sport, July 3).
Why is this behaviour accepted? It is the opposite of sportsmanship and I cannot believe that Wimbledon officials allow him to continue to play.
I’m even more shocked at the crowd, which cheered him on through every bullying tactic.
SIR – We watched the Venus Williams and Jamie Murray doubles match against Michael Venus and Alicja Rosolska (Sport, July 2).
It was embarrassing listening to the sycophantic BBC commentary on the Williams/Murray play. Very little was said of their opponents, who weren’t given credit for giving them a run for their money. The opponents played beautifully, but this was not discussed.
SIR – Why is it that when players (especially British) lose a tennis match they are said to have “crashed out”?
Newcastle upon Tyne
SIR – In these days of so-called green awareness, I am alarmed at the number of half-eaten bananas that are thrown away at Wimbledon.
Englefield Green, Surrey
Why import coal when Britain has its own?
SIR – It would be an act of insanity to import the coal we need for our steel industry when we have an abundance of it ourselves (Letters, June 30).
I implore Michael Gove, the Communities and Local Government Secretary, to announce the opening of the coal mine at Whitehaven, Cumbria, urgently. It will contribute to the restoration of Britain’s economic vitality.
Aneurin Bevan once said: “This island is made mainly of coal and surrounded by fish. Only an organising genius could produce a shortage of coal and fish in Great Britain at the same time.”
Cookham Dean, Berkshire
The cost of standing up to a dictator like Putin
SIR – Those who do not understand the personality of Vladimir Putin should realise that he is an archetypal dictator, following in the footsteps of Hitler, Stalin and Mao Zedong, all the way back to Genghis Khan and beyond.
His sole motivation is self-preservation. He will eliminate anyone who stands in his way, with no care for the multitude slaughtered. He will exploit any weakness by the West and Nato, with whom he never has, nor ever will, negotiate in good faith.
Our opposition must be determined and our support for Ukraine resolute. However, it will cost us, and our leaders need to be straightforward about the level of that cost. The offer from Liz Truss, the Foreign Secretary, of a further £1 billion in military aid and the Prime Minister’s pledge to spend 2.5 per cent of GDP on defence by 2030 are but small steps in the right direction.
Cdr John McGregor RN (retd)
SIR – Several letters from military professionals make a strong case for increasing spending on defence.
Considering the story of the Ajax tank programme, which has cost more than £3 billion since 2014 and is yet to deliver a single deployable vehicle, one simply asks if the Ministry of Defence is the best organisation to receive our money.
Bury St Edmunds, Suffolk
SIR – Finland and Sweden, with their highly capable and modern militaries, will soon be the new kids on the Nato block. Unlike France’s President Macron, who described Nato as “brain dead”, they clearly consider Nato membership indispensable, with Mr Putin’s war raging all over the territory of their neighbour Ukraine.
SIR – History will frown upon Nato for its lily-liveredness in the face of a defeatable Vladimir Putin. And history will be right.
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