NHS must adapt

Congratulations on your two-page spread celebrating the 72nd birthday of the NHS and its achievements (SA, July 4).

I would like to make one minor correction and a few comments.

You state that the three founding principles – free at the point of use, available to everyone, and paid for from general taxation – remain. In fact, the first of these principles (free at the point of use) had to be abandoned (because of cost) in 1952 – just 4 years after its birth – with the introduction of the prescription charge and payments for dentistry and spectacles.

Throughout the whole of its life, it has struggled to deal with the problem of demand exceeding supply.

At its birth in 1948, the conditions it treated were all life-threatening, there were few investigations (Xrays and blood tests) available, and medicines were relatively ineffective but cheap (no antibiotics or chemotherapy). Now, many of the conditions treated are life-enhancing, there are lots of investigations available (CT, MRI and US scans and complex blood tests), and many of the treatments are highly effective – but expensive.

The restrictions (by law) on working hours and the need for more highly trained professional staff continues to cause problems.

The ability to recruit and retain them has been hampered by pay restraint. And the size of management and administration has increased out of all proportion. Added to this is the fear and cost of, litigation. Last year (to Mar. 2019) the NHS Litigation Authority paid out £2.4 billion in damages; and has set aside £83 billion for pending claims! Back in 1948, suing the doctor was almost unheard of.

The NHS has come a long way since its birth; it still has a long way to go. As it has done in the past, it will have to change with the times.

It can only do so if the public continue to show the support it has shown during the COVID crisis.

We wish it well.

Malcolm Morrison

Retired Orthopaedic Surgeon

Old Town

Shadow of slavery

I must comment on David Collins’ latest attempt to rewrite the history on racism, (July 2). In his response to a letter of mine he states, “We cannot look at what happened years ago with the hindsight of today.” Of course, we can and must. This is called “learning from history”. But that is not the real point here. It is not the case that during the slave trade it was an accepted thing. Here and everywhere else slavery existed there was huge opposition to it. In Britain ex-slaves and radicals, (left wing in today’s language), fought to end slavery and more generally against racism. Indeed, one of the reasons racist ideology was developed, by slavers, planters, their ideologues and Tory supporters of the day, was as a response to the arguments of opponents of slavery. Black people had to be portrayed as less than human to justify their oppression. Mr Collins has accepted the writing out of this history, as by the way, both Swindon’s Tory MPS have recently done. Let’s not forget, Mr Collins’ original letter on this was a defence of the celebration of slavers in the form of statues. We also need to address this history because Britain’s economy was largely built on it.

Mr Collins moves on to a false story about the origins of plantation slavery. Yes, slavery has existed in human societies since social class appeared. It was always bad but didn’t tend to thoroughly and violently deny the humanity of slaves and definitely not on a racial basis and certainly not on such a devastating scale. This developed with the transatlantic slave trade, partly because of its linkage with mass production of sugar and cotton for the market. Its shadow is very much with us today.

Mr Collins then wants Britain to take credit for outlawing slavery. A wave of slave rebellions, which the British state tried to crush, made slavery untenable. That and other economic developments ended slavery but even then, the conditions of freed slaves was appalling, a situation maintained by yet more brutality.

Finally, the racism faced by the Windrush generation was not just about ignorance of a few bad apples. It was deliberately fostered by tabloids and politicians. The colour bars, and discrimination they faced had to be pushed back through active anti-racist campaigns.

Peter Smith

Woodside Avenue