Plenty of scope for improving the NHS

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There is much to be said for the excellence of the NHS in Scotland and for the Scottish Government’s commitment to its protection from the 
privateers (your report, 11 March).

From my own observations of hospital visits, treatment and anecdotes from friends, I have formed the impression that there are many ways in which services can be improved with greater consultation, training and input from NHS staff across professional boundaries.

The last Labour government made much of the additional money poured into the NHS, but we saw little evidence of attempts made to change the structures and ethos imposed by the Thatcher government. It has always seemed that trainee doctors are under the management of consultants, who may themselves have received no management training.

Conditions for young doctors have certainly improved with the European directive on working hours, but I wonder how many young female trainees have rejected training for specialist posts because of the lack of family-friendly hours and holiday arrangements.

There is much public discussion about patient diets in hospitals. It does seem ironic that in this age of competitions for best television chefs that we seem to find it so difficult to provide patients with attractive, nutritious food to tempt the appetite of those for whom food is a key part of recovery.

The most common criticism that you hear from people who have been recent patients is that of uncaring attitudes among some staff and poor communication with patients.

I do not know if this relates to levels of agency staff or 
if it is the residual culture of the years when the NHS 
was to be regarded as a 
business.

But it would be to the credit of the health minister if we could begin to find ways to address these crucial issues.

Maggie Chetty

Woodend Drive

Glasgow

I read with interest the comments by Dr Izhar Khan, quite rightly rebutting the criticism that cross-border NHS treatment would be mired in red tape if Scotland became independent (your report, 11 March). Cross-
border healthcare has existed seamlessly for decades in the European Union, for instance between the Netherlands and Belgium, in all specialities. Patients are already making use of their fundamental rights as EU citizens and the bureaucracy can be considerably less than that existing in the NHS.

An independent Scotland could, in fact, benefit considerably from cross-border healthcare patients from England, with the income both to the NHS and private sector, taking advantage of research and medical developments of which Scotland has so frequently been at the forefront. The Better Together campaign is based on abject scaremongering, trying to erect borders and barriers which simply would not exist with Scottish independence.

Alex Orr

Leamington Terrace

Edinburgh