Letters: A lack of midwives

Thursday 23 February 2006 01:00 GMT
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A scandalous lack of midwives to provide hands-on care

Sir: We endorse the claim (report, 20 February) by the Royal College of Midwives that there is an acute shortage of NHS midwives. As the authors of a recent report by the independent think-tank Reform on maternity services, we calculated that the number of midwives fell over the last decade, while the number of babies born remained constant.

The Department of Health's response in your article - that the number of midwives working in the NHS has increased by 2,500 since 1997 - does not acknowledge the shift away from full-time working towards part-time working and the consequent reduction in overall hours worked. Furthermore, over this period midwives' duties have increased enormously leaving less time available for their most important role: to care for women in labour.

Our other main finding was that the concentration of deliveries into large maternity hospitals has gone further in Britain than elsewhere in Europe. The largest maternity hospital in Belgium delivered 2,641 babies in 2004; well over half (110 out of 186) of English maternity units are larger than that. Liverpool - the largest UK unit - delivers over 8,000 babies per year.

There is no evidence that such large units are safer than smaller ones nor that they offer economies of scale. Neither is it clear that they are popular with parents or midwives. The future for maternity services is for integrated systems of care involving co-operation and networks between high- and low-risk providers with much greater use of smaller and more local midwifery-led units. This will improve choice and care for mothers.

We believe that the provision of care for pregnant women and their babies should not continue to be driven by an ideology of centralisation without any clear rationale. Nor should the scandalous lack of midwives providing "hands on" clinical care be brushed under the carpet by numerical sophistry.

JIM THORNTON

PROFESSOR OF OBSTETRICS AND GYNAECOLOGY, UNIVERSITY OF NOTTINGHAM JEN FERRY PCT DIRECTOR AND RECENT HEAD OF MIDWIFERY CHRISTOPH LEES NHS CONSULTANT IN OBSTETRICS AND FETAL-MATERNAL MEDICINE LONDON SW1

Our 'ethical' army's abuses in Iraq

Sir: In his speech at King's College London, John Reid, the Defence Secretary, referred to the "deeply ethical" British Army following recent abuse allegations in Iraq. He said they are operating in "difficult and dangerous circumstances". This follows comments by Donald Rumsfeld in the aftermath of the Abu Ghraib abuse about "a few bad apples in an otherwise good barrel".

Such statements run counter to longstanding psychology experiments, such as Dr Philip G Zimbardo's 1971 Stanford prison experiment. Recently speaking about Iraq, Dr Zimbardo said that without "strict leadership" and "transparent oversight" to prevent abuse of power, that power in the circumstances described by Mr Reid will breed abuse.

This is not a case of a few sadists, but decent people being propelled into indecent situations and resultantly committing abuses. Decent human beings in indecent environments without "strict leadership" from the highest echelons of authority - Reid and Rumsfeld, Blair and Bush - inevitably commit acts they would otherwise not even fathom.

Such statements by both Mr Reid and Mr Rumsfeld only indicate their lack of understanding of the root causes of these problems whilst also failing to provide the "strict leadership" called for by Zimbardo and others. Reid actively called for a reduction in the required "transparent oversight" in his comments about critics being "a little slower to condemn and a lot quicker to understand".

MATTHEW BARR

FISHBOURNE, WEST SUSSEX

Sir: Dr Reid's plaintive pleas that we ignore the transgressions of our soldiers for fear that al-Qa'ida may use them as propaganda have the ring of a pretty feeble excuse for an appalling act of brutality. Dr Reid states that the "terrorists have become adept at using the media for their own ends". Perhaps they saw the headline "45 minutes from doom".

The images will doubtless have provided yet further recruitment posters for al-Qa'ida, but for Dr Reid to seek to portray this as the fault of the media, not of the soldiers, draws directly from the Goebbels school of propaganda in which all dissent is unpatriotic.

G WHITTAKER

READING

Philosophy is for grown-ups

Sir: It was Plato who apparently refused to teach his philosophy to any pupil under the age of 40 and I can understand why ("What is the point of philosophy?", 17 February).

I recently completed a philosophy degree in my middle years and with great struggle attained an upper 2:1, of which I am very proud. Philosophy is a very demanding degree intellectually and is not for the faint-hearted. However, Plato had a point in asserting that one has to live first in order to take on deep philosophical issues that are at best puzzling and without conclusion; this type of contemplation forces one to think but not really to understand. Understanding comes with life and experience.

It is true that now I am looking for employment my philosophy qualification could only take me on to teaching; young people who want to work in the modern world and make money should forget philosophy and concentrate on practical qualifications that help them serve society and themselves. They can do philosophy when they are older and have the luxury of time to think about life on a deeper level. A C Grayling is a teacher and writer of the highest calibre and not everyone can be an Oxford professor.

LAURA MACLEOD

MINSTER LOVELL, OXFORDSHIRE

UK on course to meet Kyoto targets

Sir: Michael Harrison has got his figures confused (18 February). The UK is on track to meet its Kyoto targets for reducing greenhouse gases and will probably well exceed them.

The Kyoto Protocol requires the UK to reduce greenhouse gases by 12.5 per cent below 1990 levels. These gases include not only carbon dioxide but also methane, nitrous oxide and some gases containing fluorine. The latest figures show these gases down around 14.5 per cent, one of the best records for any industrial country, and estimates suggest the fall will be about 20 per cent by between 2008 and 2012, the end of the target period. To date, carbon dioxide emissions have fallen by between 10 and 11 per cent.

In addition to its Kyoto obligations, the Government has a voluntary domestic target to reduce CO 2 emissions by 20 per cent by 2010, one of the most ambitious for any country. We need further action to get back on track towards this and we will announce measures soon to this end.

The UK is proud of its climate change programme, but we never said it would be easy. In common with all industrial nations CO 2 has risen in the UK in the last few years due to movements in energy prices. We are confident we can cut emissions in future and it is essential that we all, industry, public sector and individuals, play our part in doing so.

ELLIOT MORLEY

CLIMATE CHANGE AND ENVIRONMENT MINISTER LONDON SW1

Sir: I wonder whether Thomas Sutcliffe chose his words with due consideration in his eulogy to windmills , as he calls them ("Sublime poetry in motion", 21 February).

The picture shows the four wind turbines which Yorkshire Water Services commissioned at Chelker Reservoir in 1993. They do not mill any corn, although I suspect that they grind teeth in their gearboxes. It is perhaps a reflection of how intermittently they harvest the wind if this is the first time you have "seen all of them working"?

How you view them depends on your perspective and how green you are - I choose both words for their ambiguity. I have had wind turbines towering 80 metres above my home at less than 500 metres distance since 1995, and I am sorry to say that they do not "dwindle into the landscape", and their very sight and sound (yes they do make a noise) has dampened not lifted my spirits for many a long year.

MARK TAPLIN

TRURO, CORNWALL

America honours a British conqueror

Sir: The Independent incorrectly spelled the name of Amherst College as "Amhurst" in the CV that accompanied Paul Vallely's profile of Joseph Stiglitz on 20 February. Notwithstanding that alumni of Amherst might view the misspelling as akin to an American publication misspelling "Oxford" or "Cambridge," this is an amusing error for a British publication to make.

After all, Amherst College (and the western Massachusetts town in which it is located) owes its name to Lord Jeffery Amherst, the commanding general of British forces in North America during the later stages of the mid-18th century conflict known to Americans as the French and Indian War. Indeed, Amherst College still maintains at least two links to its British namesake: "Lord Jeff" still occupies his place as the mascot for the College's athletic teams and his exploits are recounted in the lyrics of the school's fight song.

DAVID E NARDOLILLO

ROSEVILLE, MINNESOTA, USA

The dissident in the royal palace

Sir: The Independent is to be congratulated for its ironic juxtaposition of Robert Verkaik's article (22 February) on Prince Charles, the self-styled dissident, with a sidebar on well-known real-life dissidents.

Those who have taken part in letter-writing on behalf of political prisoners who have suffered for their courage and commitment will have certain images called to mind by the word "dissident". These do not include a rich landlord living in a palace, with influential contacts in politics and the media, and with squads of lawyers to assist him.

For those of republican persuasion, the latest controversy surrounding the Prince's intervention in public affairs may recall Roy Hattersley's words: "No one cares what the son of the President of the German Republic thinks about modern architecture".

DANIEL BAIRD

GLASGOW

Indian heroines who fought Hitler

Sir: While Noor Inayat Khan undertook a daring engagement in France that cost her her life ("The princess who became a spy", 20 February), another Indian, Princess Indira of Kapurthala, was busy in London with rescue work, driving St John's motor ambulances during the raids.

In 1942 she became the "Radio Princess" with her BBC programme in Hindustani broadcast three times a day for Indian forces in the Middle East and the Mediterranean. For a time she was also responsible for postal censorship.

These women showed their "Britishness" to an unimaginable level of loyalty to the British Crown during the Raj. Their contributions during the war must not remain simply footnotes to its history.

KUSOOM VADGAMA

LONDON NW11

Irving sentence sets worrying precedent

Sir: The draconian sentence passed on David Irving in Vienna sets a dangerous precedent. I see no reason why similar legislation should not be promulgated to indict, even retrospectively, those hundreds of academics, intellectuals and politicians who for decades tacitly or openly condoned or denied the crimes committed by Stalin and Mao among others.

DAVID HEALD

CANTERBURY

Sir: With regards to Holocaust denial, I wonder if George Bush thinks both sides of the argument should be taught at school as he does with "Intelligent Design"? "Intelligent Design" is not real science. Holocaust denial is not real history.

ISHFAQ MALIK

MANCHESTER

Life's victory

Sir: If my bones were at Verdun (letter, 22 February), I can think of nothing better calculated to warm my spirit, wherever that might be, than the sight of French schoolchildren "skylarking about".

TIM HINCHLIFFE

BECKENHAM, KENT

Liberal resurgence

Sir: Is it so surprising that the Liberal Democrats are back on 21 per cent according to the latest opinion poll? Their weakness has always been a lack of clear positioning and policies. Now the other two parties share that weakness as they both join the Liberals in the crowded centre ground. Now that voting for a political party has as much significance as voting for a colour of wallpaper, "orange" has as much of a chance as "red" or "blue". In fact it has more, because orange revolutions are in fashion.

MARK CORNER

BRUSSELS

Orwellian nightmare

Sir: I read with interest your report interviewing John Sentamu and his criticism of US activities in Guantanamo Bay (18 February). Whilst I can sympathise with his opinions, did he mean to refer to Orwell's book 1984, not Animal Farm? I'm not sure anyone has suggested the US is trying to create anything as abhorrent as a Communist collective there!

ANDREW GILBERT

LONDON SW9

English football?

Sir: I had to smile when Huw Edwards announced on the BBC News that Arsenal had become the first "English" team to win at Real Madrid. The only Englishmen on the pitch on Tuesday were playing for Real - one of them went off injured and the other, David Beckham, had a bit part. As Jimmy Greaves used to say: "Football's a funny old game."

CLIVE GOOZEE

BRIGHTON

The end of the show

Sir: To help David Lister ensure he does not miss any more encores (The Week in Arts, 18 February), can I proffer a few pointers? Have the roadies turned amplifiers off (look for the red lights)? Have the musicians walked off, waving their instruments above their heads (do not count drummers or double bass players)? Have the house lights come on? By following these few simple rules Mr Lister may never miss an encore again.

DAVID R POLLARD

HECKMONDWIKE, WEST YORKSHIRE

In good company

Sir: Sir Ben Kingsley's insistence on using his title in his billing (report, 21 February) will not faze Americans, who will doubtless place him in the same tradition as Duke Ellington, Count Basie, Lord Buckley, Queen Latifah, King Pleasure and Sir Mixalot.

ELLIN STEIN

LONDON NW3

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