Hermione Eyre: Uncaring, unethical – and a risk to us all

Monday 04 August 2008 00:00 BST
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Compelling as it is to discuss David Miliband's little finger (isn't the way he waves his hands about just so Blair?), there are other issues that the party political personality contest should not completely obscure. Yesterday we learnt what Alan Johnson would rather we didn't know: that government policy on healthcare access for failed asylum-seekers is worryingly out of step with medical opinion. The more you look at the scheme, the more you think it is out of step with common sense as well.

In 2004, the Government published proposals for restricting the kind of NHS care that overseas visitors would be able to receive. They ruled that asylum-seekers would only be allowed free access to treatment in emergencies, and in the case of a handful of infectious diseases such as TB and HIV. All other care would need to be paid for. Now, restrictions are never popular. It is easier for governments to give than it is for them to take away. But experts seem to be pretty sure that these are not the right kind of restrictions, neither ethically nor in terms of cost-effectiveness.

Responses from the medical profession were invited – and yet four years later, those responses have still not been officially published. They were perhaps a little too inconvenient. Yesterday they came to light (having been obtained by the medical student and activist Tom Yates, of the Global Health Advocacy project, who approached each respondent individually). Three quarters felt the new rules would contravene their ethical duty of care to a patient, as set out by the General Medical Council, while 68 per cent of the medical professionals consulted believe the plans would risk letting infectious diseases go undiagnosed and unvaccinated. The first issue is complex. It is never going to be easy to reconcile the reality of finite NHS resources with Hippocratic idealism. But the second issue is more simple.

Under the new ruling, GPs would not be allowed to vaccinate against diseases such as measles, diptheria and pertussis (whooping cough), or dispense medicine for diabetes, asthma etc. They would, on the other hand, be able to treat these cases when full-blown and presented at A&E. What happened to the old adage of prevention being better than cure? It is best in terms of an individual's experience, and it is best in financial terms, too: an appointment with a nurse costs the NHS £9; an attendance at A&E costs £110. One day in intensive care costs £1,387.

There are implications for the wider society too, in the case of infectious diseases such as measles. One GP, Dr Helen Sykes from Middlesbrough, warned of the risk of a recurrence of epidemics. And further caveats were put on the Government's proposals from bodies such as the Royal Society for the Promotion of Health, which points out that while cases of TB would still be eligible for treatment on the NHS, patients would often be unlikely to self-diagnose. The process of reforming the NHS is always going to be fraught and cutbacks are never popular. But it was wrong for the Government to suppress the responses of healthcare professionals. Shutting down debate helps no one.

There's nothing like a night under canvas

Camping out is "in", with Millets, Blacks, Ellis Brigham and Tesco Direct all reporting a brisk trade in canvas. Not that tents are made from canvas any more, of course. They are now all crackling Polyethelene, plastic exoskeleton and luminous guy ropes. They have articulated Durawrap poles that spring together in your hand. They have modish patterns printed all over the flysheet. Some of them even come tightly packed, ready to explode into shape when you throw them on the ground. Oh yes, sir, tents have evolved from the days of Carry on Camping.

But human hearing has not. You can still hear everything your fellow campers are saying. And they can still hear you. But somehow, inside your respective palaces of plastic, you both forget and witter away unselfconsciously. Snatches of conversation float across the country air.

You can collect the most wonderful banalities. I overheard a couple having a spirited row about the inflation of their mattress. He thought he had pumped it enough; she disagreed. The continued wheezing of the pump indicated who won. Tents are plastic pods now, but the ground is just as hard, and camping will always be something of an endurance test. On the second night at Latitude festival, I overheard the plaintive: "It's not quite so much fun as last night, is it?"

The journey of a lifetime

This week a living legend appears on television. In the third of his series about great travel writers, Benedict Allen follows in the footsteps of Patrick Leigh Fermor – right up to the door of his home in Greece, where he lives and writes.

Fermor is 92 and it was – truth be told – a marvellous revelation to me that he might still be available for interview. He still exudes the charm that opened doors to him all across Europe – and also some of his eccentric optimism, too.

When Allen asks him what has become of the third instalment of his travel trilogy, concluding the epic journey he made from Holland to Istanbul before the war, Fermor reassures him that, a lifetime on, the book is half-way there: "I'm doing my best."

In his case, we know the wait will have been worthwhile.

* Greenwash, greenwash, everywhere: eco-catchphrases are becoming increasingly mindless. On sale in Boots is a new fabric bag emblazoned with the slogan "100 per cent gorgeous. 100 per cent reusable". All very nice, but isn't that a logical impossibility? Surely a shopping bag is either reusable or it isn't. You can't be a little bit pregnant and a bag can't be three-quarters reusable. Perhaps I am quibbling (the target beauty shopper ain't Kurt Godel, after all), but it seems to represent a trend towards brainless eco-sloganeering.

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