Re your readers’ stories of the NHS (‘He stayed on that trolley in A&E for the next 12 hours’, 14 January), the government is putting out a spew of misinformation to cover the 2% reduction, as a percentage of GDP, it has imposed on funding of the NHS since 2010. The people on trolleys waiting for a bed are not the worried well who are accused of blocking up A&E departments. They are people who have already been assessed as needing beds. These beds are full not just because people cannot be moved out of hospital but because the number of hospital beds has been steadily reduced over the last 20 or more years, so that the UK now has 2.8 beds per 1,000 of population, compared with 8.6 in Germany and 6.2 in France. The forthcoming sustainability and transformation plans propose further cuts.
The government prefers to blame “bed blocking” because people are remaining in hospital “unnecessarily”. But people who are fit for medical discharge are waiting for social care packages and there has been a £4.6bn cut in social care funding since 2010. What is happening is an inevitable result of the deliberate and cavalier reductions in local government funding since 2010. The motion in parliament last Thursday, calling for extra funding for social care now and a new funding settlement for health and social care in the March budget, was rejected. Conservative MPs who have deplored the situation in their local press voted with the government. How do these MPs justify their refusal to vote to fund social care properly?
Care costs money. Whenever we in Save Our Hospital Services ask if people will pay more income tax to ensure the NHS is properly funded, there is an overwhelming “yes” in response. There is also huge anger among the public at what is being done to health and social care. The government will reap what it sows.
Save Our Hospital Services
• The illogicality of the prime minister’s response is breathtaking (Stay open seven days a week, May tells GPs, 14 January). Anyone who has been responsible for helping someone in their 80s or 90s get to the doctor will know that what is needed is a decent choice of appointments between about 10am and 5pm. Spreading appointments over extended hours will make these much harder to get, so leading to increasing numbers presenting at A&E.
It is blindingly obvious that taking the same number of doctors’ appointments and spreading them more thinly is no solution. Appointments at 7.45pm on Saturday or 8am on Sunday may suit those in work but they are not, by and large, the people arriving at A&E departments.
• The GPs have quite rightly pointed out that seven-day appointments will not work. However, it may be time for some patients to make more of an effort. To avoid an appointment interfering with my working day I can join the queue for our practice’s open access 8am surgery Monday to Friday. If I get there for 7.40am, I can be back on the street by 8.15am and get on with the rest of the day. If patients reckon that GP appointments clash with going to work, then going sick or booking half a day’s holiday may be appropriate options. If your healthcare matters to you, you have no need to slide into consumer mode.
• Is the Jeremy Hunt who stated that “We need to have an honest discussion about the purpose of A&E departments” (Hunt ditches target as A&E crisis deepens, 10 January) the same Jeremy Hunt who took his own child to A&E with a minor illness because he didn’t want to wait for a GP appointment?
Dr Clive Richards
• I am pleased that Theresa May and Jeremy Hunt are challenging the entitled approach of the medical profession. Our GPs earn double what their French counterparts do. If the BMA had not ruthlessly exploited the public esteem for doctors to access salaries and pensions beyond the dreams of other citizens, there could be many more GPs with the same personnel budget. The NHS cannot just consume our entire public expenditure – we do need to do other things with these resources.
Medical professionals need to understand that in the 21st century they are not the only people with education and skills, and that they must adjust their expectations to allow the NHS to live within its means. The public need to take the stars from their eyes and look hard at value for money in NHS spending. Aneurin Bevan said he had to stuff the mouths of doctors with gold to form the NHS – this is still true today. At last we have a government prepared to argue for realism and fairness, to allow our national spending priorities to come more into balance.
Name and address supplied
• Amid all the debate about the current crises in NHS A&E departments, the role of employer policies has attracted little attention. The growth of zero-hours contracts and the so-called gig economy means many workers have uncertain working hours. In such circumstances, committing to GP appointments is potentially problematic. Walk-in A&E departments offer an obvious way of avoiding this difficulty.
Meanwhile, a significant proportion of the workforce faces the prospect of losing pay when absent for medical reasons as a consequence of the poor nature and coverage of occupational sick pay schemes. Once again, the 24-hour nature of A&E offers a means of avoiding this problem.
Professor Phil James
• Tucked away in the bottom right-hand corner of page 4 (Rates pain for hospitals, 12 January) is news that astonishes me. I had no idea that the NHS has to pay business rates. The estimated annual sum is £377m. More disturbing, however, is the news that private providers such as Nuffield Health enjoy an 80% rebate because they are registered as charities. Private providers enjoy a rebate as charities, while the NHS is classed as a business. Verily, “For he that hath, to him shall be given: and he that hath not, from him shall be taken even that which he hath” (Mark 4:25).
• I volunteer at a nursery school. This term the theme is “people who help us”, and in a corner a hospital has been created, complete with pictures of bones, a reception desk, waiting area and bed. The children have tiny uniforms and medical equipment. The staff and I decided that for complete authenticity we need a “waiting time approximately 5 hours” sign, and make all the children wait outside in the corridor.
Crawley, West Sussex
• Join the debate – email email@example.com
• Read more Guardian letters – click here to visit gu.com/letters