Letters: Forget cottage hospitals – they didn’t work

These letters appear in the Wednesday 4th issue of The Independent

The editorial “Wards of Wisdom” (31 May) failed to contain any words of wisdom from either the writer or Simon Stevens. Cottage hospitals are mentioned without any definition of what they are or were. Well, I remember what they were like back in the 20th century, and we were glad to see them closed and replaced by district general hospitals (DGH).

They were used as a dumping ground for elderly and some not so elderly frail individuals. There was no hospital doctor cover or responsibility, and a GP would visit once a week. Most management was left to the overworked nursing staff, who did their best.

Occasionally patients would find their way over to the DGH, where any number of conditions would come to light that, once correctly diagnosed, could be treated. These cottage hospitals were closed down because they did not work.

The good old mistreated and abused NHS was built on the GPs and local district general hospitals. I fear the DGHs may be emasculated into “new cottage hospitals” under the misleading slogan “bringing your care closer to home.”

I do not like the way the leader writer and Simon Stevens are categorising people on the basis of age. Apparently according to them these people (implicitly older people) “need something different from the highly specialised, technically sophisticated treatment required for stroke victims. They need careful monitoring by vigilant staff who can spot things when they go wrong and intervene before a problem develops into a crisis. This care should largely be delivered at home and might be co-ordinated by a local hospital in a seamless service.”

This is contradictory rubbish. How can you be carefully monitored at home by vigilant staff when living alone or with a frail partner in poor-quality rented accommodation, with an inadequate number of community nurses and GPs working their socks off already? It implies that second-rate care is the fate of our ageing population unless you can afford private care.

Kenneth G Taylor MD FRCP , Consultant Physician, Birmingham

Before Labour commits itself to a big rise in NHS spending, it would do well to examine the record of the spending and performance of the service over the past ten years.

NHS net expenditure increased by 84 per cent from £57bn in 2002/03 to £105bn in 2012/13. Over the same period the number of beds available in NHS hospitals fell by 26 per cent from 183,826 to 136,487, to reach the present crisis level of 2.6 beds per thousand of population compared with an EU average of 5.3, France 6.0 and Germany 8.0.

Bed occupancy rates between 2002 and 2013 averaged 85 per cent, leading to severe overcrowding, increased risk of infection between patients, and premature discharges due to shortage of beds. Moreover, the Mid-Staffordshire NHS Foundation Trust public inquiry and the increasing number of reports of avoidable hospital deaths and cruelty by staff to patients indicate that the quality of care is deteriorating.

It is now nearly 40 years since the publication of my Theory of Bureaucratic Displacement, exemplified by the NHS. The theory indicated that: “In a bureaucratic system increased expenditure will be matched by fall in production.” Milton Friedman found that this applied to the US public school system and referred to it as “Gammon’s Law”.

The law has never been refuted, its statistical predictions have been fulfilled with precision, and its social implications have been amply demonstrated. It is time for us to take it into account before circumstances force us to do so.

Dr Max Gammon, London SE16

Boomers’ luck is not our fault

I normally enjoy Grace Dent’s column, but treating all baby boomers as one homogeneous lump, as she does on 3 June, is sloppy. None of us expected this huge rise in house prices, which pays for nothing unless we sell and downsize, nor are we necessarily happy about it, because of the damage it does to our children’s prospects.

What we did do is to work hard, pay significantly higher taxes and save for our pensions, which are, quite rightly, taxable.

The jibe that we all voted Ukip is statistically risible – the vast majority must have voted for other parties and many are quite happy to live in a culturally diverse society

One area where Grace Dent and I do agree is that we were lucky – hardly our fault – and we have absolutely no right to whinge now.

Graham Hudson, London SW19

Too few men fight for women’s rights

Yasmin Alibhai-Brown is right to ask the question “Where are all the men?” when it comes to campaigning for women’s rights (2 June).

Unfortunately, women have largely been on our own as far as protest is concerned, and while there have always been some supportive men, more often than not the male contribution to the female cause is one of intimidation and putdowns. It is therefore extremely optimistic to think that the current protest in India is likely to be any different.

Ultimately, the world is still defined in male terms and is a world in which women’s issues are something of an inconvenience.

After all, when a man needs to be able to organise his arms deal or sporting fix with some gentleman almost anywhere in the world, dear me, just how awkward it would be to bring up the topic of female rights, particularly when they can be so handily swept under the carpet of “culture” or religion.

Clare Moore, Rustington, West Sussex

Yasmin Alibhai-Brown’s contention that all men are indifferent to violence against women is nothing short of ridiculous. Of course the vast majority of us deplore acts of violence – whether against women, or children, or other men; but unlike Ms Alibhai-Brown, we do not put them in different categories.

A woman in India and a teenage boy in Peckham are equally deserving of our protection; the question is whether the brutalised minority who threaten them can be reasoned with.

Anthony Gardner, London NW10

A greeting from Yorkshire

If other parts of England are struggling with the demise of the traditional forms of greeting, including “How do you do?” and a kiss on the cheek (Rosie Millard, 2 June), may I suggest the entire nation adopts the time-honoured Yorkshire method?

With experience, the simple phrase “Eh up” can be employed to convey a wide range of emotions and can easily be adapted to meetings with everyone from complete strangers to next of kin.

Even in the mouth of a novice it can be used as a friendly but not over-friendly ice-breaker and avoids the angst associated with handshakes and kissing.

Bryan Jones, Knaresborough, North Yorkshire

Sparrows return to Dulwich

Some years ago The Independent ran stories on the decline of the sparrow population in the UK. I don’t remember the cause of this decline ever being established.

Here in East Dulwich in south London the sparrow population appears to be on the rise over the past couple of years. Although nowhere near previous levels it is heartening to hear them chirping in the hedges in the parks and streets. I wonder if any of your readers have noticed a similar increase in other parts of the UK.

Charlie Smith, London SE22

Harmony on the football field

Roy Hodgson has promised that his players will sing the national anthem loud and proud this summer, but thinks “we’re great until the second verse comes along because we don’t really know that”. The answer must be to draft in the help of Gareth Malone. A true team-building exercise. Imagine what singing in four-part harmony would do for on-field co-ordination.

Patrick Walsh, Eastbourne

John Moore claims that men’s sport is “superior in terms of skill, strength, power and entertainment to women’s” (letter, 2 June).

I watched the women’s FA Cup Final at the weekend, and what a pleasure it was. No cheating, diving or play-acting. No pushing or shirt-pulling at set-pieces. No whingeing or berating of officials. And no spitting. Men’s football could learn much from the women’s game, if the authorities had the courage.

Keith O’Neill, Shrewsbury

Still a prince in waiting

Given how long he has been waiting, it does seem harsh that when a vacancy appears for a European monarch Prince Charles is apparently passed over without even an interview for the job.

Keith Flett, London N17