The NHS is designed to guard our nation’s health, not our borders

Please send your letters to letters@independent.co.uk

It has been suggested that doctors ask patients to see a form of ID before treatment (PA)

So it’s proposed that passports will be needed to access NHS care. Every time the Government opens its mouth about the NHS, it involves more, pointless bureaucracy.

If this ridiculous plan is to be adopted just who will check the ID? I suspect each trust will employ a director (and assistant director, of course) of passport-checking and pay each one around £100,000.

Anthony Ingleton

Sheffield

It appears that since July 2015, when Prevent became a statutory duty on those working in the health sector, the NHS referred 420 patients and staff to police in England and Wales in a year over concerns they were at risk of radicalisation, which equates to an average of 35 referrals a month.

But as a doctor I have questions. I have spent years ensuring my consulting room is a safe space for patients to talk confidentially about their problems with the reassurance given that confidentiality will only be broken as per General Medical Council guidance, but can I still give that assurance when with Prevent the threshold for breaking confidentiality seems lower?

It’s frustrating as a doctor to think my patients may not fully disclose information to me because I am expected to make complex nuanced judgments as to whether patients buy into British values, and my ability to question freely is now hindered because of a fear of “mistrust” by the patient. This lack of information offered by the patient may also mean they aren't accessing the treatment that may be right for them.

For me as a doctor, safeguarding has always prioritised the welfare of the patient at issue, whereas with Prevent the priority doesn’t appear to be the patient but is about protecting the state from violent and non-violent extremism. This precedent is especially worrying where the patient concerned is a child.

Nine out of ten referrals to Prevent from the NHS are found to have no risk of radicalisation after assessment. Surely there is something significantly wrong with the programme for such a large proportion of referrals to be deemed as needing no further action, compared with an average of 37 per cent within safeguarding? What happens to these patients when they have been through the stigmatisation of a Prevent referral? How long is data stored on these individuals and where? There appears to be no support, monitoring or follow-up for these patients, many of whom are referred without their knowledge or consent. Surely the lasting trauma these patients – especially the children – experience goes against safeguarding’s primary consideration of serving the best interests of the child?

All other areas of safeguarding are subject to clinical governance and audit to ensure best practice is occurring. This does not appear to be happening with Prevent. Is this because the duty is being driven down on authorities by security officials rather than practitioners? Access to data on Prevent referrals is limited and there is no transparency compared to safeguarding. This is not best clinical practice.

Siema Iqbal

Cheadle

Coverage of the war in Mosul

Right now we are bombarded with photos of children being pulled out of the rubble, people dying, hospitals being bombed and the wanton destruction of that city by Russia and Assad.

Recently Britain and America have started bombing a similar sized city in Iraq called Mosul and the coverage is utterly different. We are not subjected to daily film footage of what our bombs are doing to civilians in the same way as in Aleppo.

Mark Holt

Liverpool

The UK and the US’s one thing in common

After the EU referendum, I felt ashamed to be British. Now, after Donald Trump, I feel ashamed to be human.

Americans and Brits share one thing: a sense of misplaced superiority. When Trump supporters act so smug and superior to the outside one can easily recognise severely misplaced superiority especially on the part of Trump. Presumably this is how Brexiteers look to other Europeans.

Hamish M Ireland

North Berwick

We owe it to the young to stay in the EU

J Gaskell's letter (This Brexit shambles needs to stop, 20 November) was excellent. I do feel that many used Leave as a valid protest vote. Of course, we know this wasn’t what it was about, and the Brexit leaders were so colourful. But those leaders haven’t the slightest interest in those people who felt the need to protest. I live in London, and there’s a lot of need here too. The EU is our future, and our Westminster Government is anything but the place which will support us when we need support. Those who have access to “power” must do what they can to think seriously about the 23 June “result” and make good come from it, along with our friends in Europe. We must remain and build a future together – we (I’m 69) owe that to our young folk.

Ian Press

Address supplied

The Pontypool pound

The deprivation of Pontypool has made a British national newspaper. Why should the inhabitants of this town and similar ones right across these blighted isles have to pay tax direct to the Treasury in London? Wouldn't the tax be better kept at a local level in order to revitalise the local economy?

This is where a local currency comes in. A local bank would be established to issue electronic Pontypool pounds to be circulated locally, nourishing those parts that the Chancellor fails to reach. Employees would elect to receive a proportion of their pay in tax-free epounds that could only be spent at local businesses and services, thereby continuously benefiting the local community.

Geoff Naylor

Hampshire

Ambassador Trump

So, having “saved” us from surrendering our sovereignty to unelected bureaucrats in the EU, Donald Trump has requested that Nigel Farage becomes our unelected bureaucrat in the US. Oh, what brave new world is this that has such noble and self-sacrificing people in it?

Julian Self

Milton Keynes