WHAT neither Drs John Elliott nor Hamish Maclaren in their letters of January 9 and 10 mention as an important cause of the NHS meltdown – and is a good example of government mismanagement – is the new contract that was offered to general practitioners in 2004 by the Labour Government. This allowed GPs to opt-out of 24-hour responsibility for their patients. So, no more evening, night or weekend on-call that had been the backbone of the service. The great majority of GPs took this up at minimal financial cost to their incomes.
Unsurprisingly, attendances at accident & emergency departments increased, almost doubling in the subsequent decade, and they have continued to escalate. GPs and the British Medical Association will cry "foul" that the two events are causally related and will point to increasing age and patient demand as explanations These are factors but neither age-demographics nor societal attitudes can have changed by nearly 100 per cent in one decade.
NHS 24 and similar phone-answering services were introduced but could never effectively replace GPs. The resulting chaos at A&E is something the medical profession should take some responsibility for. It's a major contributor to the NHS meltdown we're witnessing.
Dr Stefan D Slater (retired consultant physician),
80 Whitehouse Road, Edinburgh.
AT the end of this month, the Scottish Government will close its consultation on its forthcoming Diet and Obesity Strategy.
We hope by then it will have gathered a wealth of evidence to show that regulations to restrict multi-buy offers on unhealthy food and drink would be crucial in helping to stem the rising tide of obesity in Scotland.
There can be no doubt that a bold strategy is needed. Scotland has been in the grip of an obesity epidemic for too long.
Not only is Scotland one of the heaviest nations in Europe, but Scots also buy double the amount of food and drink on price promotion than shoppers on the Continent. The Scottish Government’s commitment to limit junk food marketing is a step in the right direction but, to progress, regulations are needed to restrict multi-buy offers on unhealthy food and drink.
Obesity is linked to 13 different types of cancer. As part of its forthcoming obesity strategy, the Scottish Government must grasp the opportunity to help families make it easier to keep a healthy weight.
Measures to help us enjoy a better diet and fill our shopping baskets with healthy food will make it easier for us all to stack the odds of not getting cancer in our favour.
Professor Linda Bauld,
Cancer Research UK,
9-10 St Andrew Square, Edinburgh.
YOU report that there is a queue of nurses trained in Scotland waiting to take up suitable posts abroad (“Hundreds of Scottish-trained nurses planning to work abroad”, The Herald, January 5). This situation is intolerable.
In countries in the Americas, Asia, Australasia and Europe, healthcare professionals are treated with respect and are relatively well paid for what they do.
By contrast, in the UK they are almost taken for granted, and only become the subject of attention when something goes wrong.
I would suggest one possible solution is the setting up of an independent review body to examine terms and conditions within the NHS, bearing in mind the economic climate prevailing at the time. This entity should not just meet as a one-off, but be an on ongoing annual review body which makes recommendations, based on independent fact gathering, prior to negotiation between management and workforce taking place.
This would be beneficial not only to those engaged in the NHS but also to people like me who have a tendency to take for granted some of the benefits and good work offered by the NHS staff in Scotland.
Brian T McFarlane,
14 Balmoral Drive, Cambuslang.
Why are you making commenting on The Herald only available to subscribers?
It should have been a safe space for informed debate, somewhere for readers to discuss issues around the biggest stories of the day, but all too often the below the line comments on most websites have become bogged down by off-topic discussions and abuse.
heraldscotland.com is tackling this problem by allowing only subscribers to comment.
We are doing this to improve the experience for our loyal readers and we believe it will reduce the ability of trolls and troublemakers, who occasionally find their way onto our site, to abuse our journalists and readers. We also hope it will help the comments section fulfil its promise as a part of Scotland's conversation with itself.
We are lucky at The Herald. We are read by an informed, educated readership who can add their knowledge and insights to our stories.
That is invaluable.
We are making the subscriber-only change to support our valued readers, who tell us they don't want the site cluttered up with irrelevant comments, untruths and abuse.
In the past, the journalist’s job was to collect and distribute information to the audience. Technology means that readers can shape a discussion. We look forward to hearing from you on heraldscotland.com
Comments & Moderation
Readers’ comments: You are personally liable for the content of any comments you upload to this website, so please act responsibly. We do not pre-moderate or monitor readers’ comments appearing on our websites, but we do post-moderate in response to complaints we receive or otherwise when a potential problem comes to our attention. You can make a complaint by using the ‘report this post’ link . We may then apply our discretion under the user terms to amend or delete comments.
Post moderation is undertaken full-time 9am-6pm on weekdays, and on a part-time basis outwith those hours.
Read the rules here