Readers' letters: Think the unthinkable on health insurance

Since Tony Blair’s government agreed an unprecede nted pay package for GPs in the UK – from which they became the highest paid in Europe – our previous 24-hour GP service cover has declined over the years to an average of 30 per cent of what it was, with no out-of-hours service offered in many instances, combined with three-day weeks and much part-time GP working adversely affecting the health of the nation.

The recent Covid pandemic has highlighted this disconnect, with the resultant overload at Accident and Emergency and other hospital services which is unsustainable.

Politicians are averse to confronting the vexed issue of pay and conditions or even considering a more effective German health insurance model which has resulted in the the best provision in Europe for both well-paid GP and intensive care services.

Edinburgh has a world-renowned insurance services business which could easily work with our government to devise an economic health funding alternative – perhaps on the German model – for Scotland, if not the entire United Kingdom.

Hospital services are under massive pressure

Meanwhile, can we not at least have GPs and pharmacists co-ordinating to provide grouped local out-of-hours services to be advertised and offered throughout Scotland? This would provide an effective preventive care service and take an intolerable pressure off our hospital services whilst likely reducing the excess death rates we are now enduring.

Elizabeth Marshall, Edinburgh

NHS ‘rationing’

Well before Enoch Powell became notorious for his “Rivers of Blood” speech, in the early 1960s he had been one of the longest serving Ministers of Health south of the border, holding at the time liberal views about immigration.

He is remembered for his work to close old-fashioned mental hospitals, and his efforts to reduce NHS waiting lists, which in England during his tenure fell from 475,643 to 470,297 But they then quickly rose, to 498,972.

His ministerial stint caused him to regard waiting lists as a fundamental property of the NHS, a form of rationing. It is hard to disagree with his statement that the public was encouraged to believe that rationing in medical care was banished by the NHS, with the very idea being immoral and repugnant, and that there is a political convention that its existence must be strenuously denied.

In the 1960s it was possible to get away with such views, because in comparison with today the numbers were so small. But more than three quarters of a million Scots are currently waiting for health care. It is not surprising that NHS chief executives are thinking the unthinkable regarding radical reforms!

Hugh Pennington, Aberdeen

Beveridge’s plan

Congratulations to Martyn McLaughlin for his thought-provoking discussion of Beveridge and his report in the current unsettling context (Scotsman, 30 November).

Briefly a Liberal MP, Beveridge continued to support his 1942 Plan although many claimed he had moved away from it in favour of voluntary action. Iain Duncan Smith, for example, said that Beveridge's 1948 Voluntary Action was better than his 1942 report, but I doubt he had read it carefully enough. Beveridge began the last chapter, First Things First, writing that his 1942 report had the goal of "bread and health for all at all times before cake and circuses for anyone at any time”.

That is very different to current government thinking. Beveridge attacked “the evil of inequality” and argued for the prevention of poverty, much more in line with Harold Macmillan, later a Tory Prime Minister, in his 1938 The Middle Way: “Freedom and poverty cannot live together. It is only in so far as poverty is diminished that freedom is increased.”

Adrian Sinfield, Edinburgh

Nuclear law

Like many thousands, I was outraged at the Supreme Court’s denial of the democratic will of the people, and took myself off to Donald Dewar’s statue to protest. Because we are all much concerned with observing the law, aren’t we?

Or are we? On 22 January, 2021 the Treaty on the Prohibition of Nuclear Weapons became effective. This was the first legally binding international agreement to comprehensively prohibit nuclear weapons. It is now illegal under international law to develop, test, produce, manufacture, acquire, possess, stockpile, transfer, use or threaten to use nuclear weapons.

This is “ius cogens” that is, compulsory law, that means a peremptory norm from which there is no derogation (like piracy, genocide, FGM, or enslavement), as opposed to customary law, where parties have made a mutual agreement. I make this point in response to the obvious question – what do we do if this law is simply ignored by rogue states? The answer is that nuclear weapons will be delegitimised, and those who have them will be stigmatised. They may perversely persist, but their criminality will be blatant and indisputable. The rogue nuclear nine states are manifestly criminal,

Back to Scotland and the law. Will we, the ordinary people, continue to accept the abomination of Trident? Will the officers of the law (the police) just carry on as usual arresting those who attempt to uphold the law by peacefully and non-violently disrupting the ongoing crime of Trident, or will they desist from being complicit in this and arrest those carrying hydrogen bombs along the roads of Scotland?

Will they stop the nuclear convoys at the border, and if not, why not? We look to the police to protect the innocent and the weak from arbitrary violence from the powerful, even when violence is done by the state.

Is it unreasonable to hope our police will find the courage and integrity to respond to the unique situation in Scotland, where illegal weapons of mass destruction are flaunted by the state?

Brian Quail, Glasgow

A new old anthem

I must agree in part with Sandy MacPherson's comment about the English team playing God Save the King (Scotsman, 1 December), as it now is, as their national anthem.

As he says, it is the British national anthem and, to my mind, all the different British teams should use it, as we used to. Flower of Scotland is a total dirge, as most agree and, in common with Scots Wha Hae is fundamentally not a celebration of Scotland so much as a battle hymn against King Edward I of England who, by all accounts, has been dead for rather a long time.

What better statement of our decision to remain part of the United Kingdom could there be than such an affirmation of our proud, collective identity?

Andrew HN Gray, Edinburgh

Blackford’s exit

The resignation of Ian Blackford as Westminster SNP leader raises a number of questions. First and foremost is: did he fall or was he pushed? Rumours of a move against him among his Westminster colleagues were scotched by the alleged prime mover, Stephen Flynn, MP. I doubt, though, that any of it came as a surprise to Nicola Sturgeon, without whose approval, or even insistence, Blackford would not have resigned.

It is unlikely that the new incumbent will be Joanna Cherry, one of the few effective SNP MPs. She was sacked from her front bench post for opposing the Holyrood SNP’s gender recognition reform, which seems to have become a totemic issue for Sturgeon. After his performance in the Commons this week, after leaking part of a letter from the Speaker, it is highly unlikely that John Nicolson will be in the frame, whatever his ambitions. Pete Wishart’s incoherent support for Nicolson in the Commons could rule him out, too. Stephen Flynn may well, of course, be a contender, whatever his protestations. But had anyone heard of him before the alleged plot against Blackford? The SNP MP most anxious to burnish his profile, Alyn Smith, will undoubtedly throw his hat into the ring – if in the tightly-controlled world of SNP internal politics there is a ring at all.

Whoever succeeds the Reverend I.M. Jolly soundalike will predictably continue his tedious and frankly wrong repetitive “we was robbed” claims. Having some 47 MPs, the SNP has had a great chance to make a real contribution to legislation and debate at Westminster, had it been prepared to act constructively. But whoever succeeds Blackford will continue to act as a massive wrecking ball, contributing nothing of value to the UK and merely embarrassing Scotland.

Jill Stephenson, Edinburgh

Money talks

Is it true that Ian Blackford is stepping down as SNP leader at Westminster to spend more time with his money?

Mark Boyle, Johnstone, Renfrewshire

Brexit turkeys

Next year is going to be a tough year for the UK economy. Sleepwalking into recession and delivering the worst economic performance of all G7 countries, with Brexit a fundamental cause of this.

Further evidence, if any were needed, of the damaging impact of Brexit, is the recent research by the Centre for Business Prosperity at Aston University. This has found that withdrawal from the European Union and the introduction of the EU-UK Trade and Cooperation Agreement has resulted in a 22.9 per cent slump in UK exports.

According to this research, the UK has also experienced a significant contraction in the variety of goods being exported to the EU, with an estimated loss of 42 per cent of product varieties.

This considerable contraction of the UK trade capacity, combined with an increased concentration of export values to fewer products, signifies some serious long-term concerns about the UK’s future exporting and productivity.

It is yet another example, to add to the growing list, of Brexit being one of the greatest acts of economic self-harm by a nation and is a perfect case of where turkeys have indeed voted for Christmas.

Alex Orr, Edinburgh

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